Provider Demographics
NPI:1396560256
Name:DAVIS, HUNTER CHRISTIAN
Entity type:Individual
Prefix:
First Name:HUNTER
Middle Name:CHRISTIAN
Last Name:DAVIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7102 COUNTY ROAD 3704
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TX
Mailing Address - Zip Code:75752-5057
Mailing Address - Country:US
Mailing Address - Phone:903-681-3680
Mailing Address - Fax:
Practice Address - Street 1:7102 COUNTY ROAD 3704
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75752-5057
Practice Address - Country:US
Practice Address - Phone:903-681-3680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-16
Last Update Date:2024-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1012337163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse