Provider Demographics
NPI:1740711381
Name:DAVIS, FLOYD P JR
Entity type:Individual
Prefix:
First Name:FLOYD
Middle Name:P
Last Name:DAVIS
Suffix:JR
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 1:215 SAND BEACH BLVD
Mailing Address - Street 2:APT 908
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-4553
Mailing Address - Country:US
Mailing Address - Phone:504-256-6393
Mailing Address - Fax:
Practice Address - Street 1:215 SAND BEACH BLVD
Practice Address - Street 2:APT 908
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-4553
Practice Address - Country:US
Practice Address - Phone:504-256-6393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-24
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health