Davenport, Judith A
Davenport, Judith A is an individual health care provider with primary practice located at 5605 N Macarthur Blvd Ste. 220, Irving TX 75038-2617. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Davenport, Judith A can be contacted via phone (972) 714-0007.Contact Information
Primary practice address
5605 N Macarthur Blvd Ste. 220
Irving TX 75038-2617
Phone: (972) 714-0007
Fax: (972) 714-0009
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 508432 | Texas |
Profile Details
| NPI number | 1083719272 |
|---|---|
| LBN Legal business name | Davenport, Judith A |
| Credentials | Certified Registered Nurse Anesthetist (CRNA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 13th, 2006 |
| Last updated | Jul 8th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083719272 | NPPES |
| Texas | Other | 7419463831 | TAX ID |
| Texas | Other | 83562U | TAX ID |
| Texas | Other | 81143U | TAX ID |
| Texas | Other | 83892U | TAX ID |
| Texas | Other | 85385U | TAX ID |
| Texas | Other | 88421C | TAX ID |
| Texas | MEDICAID | 089061804 | TAX ID |
| Texas | Other | 113718318 | TAX ID |
| Texas | Other | 562365185 | TAX ID |
| Texas | Other | 743018935 | TAX ID |
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