Provider Demographics
NPI:1467031252
Name:DAVIS, CHERYL YOLANDA
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:YOLANDA
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6614 EZZARD CHARLES LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77091-1722
Mailing Address - Country:US
Mailing Address - Phone:832-739-1690
Mailing Address - Fax:
Practice Address - Street 1:6614 EZZARD CHARLES LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77091-1722
Practice Address - Country:US
Practice Address - Phone:832-739-1690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX908577376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty