Basic Information
| Provider Information | |||||||||
| NPI: | 1295880839 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DAVIES | ||||||||
| FirstName: | SUAD | ||||||||
| MiddleName: | BILKISS | ||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 17207 KUYKENDAHL RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | SPRING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773798423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8326985320 | ||||||||
| FaxNumber: | 8326985171 | ||||||||
| Practice Location | |||||||||
| Address1: | 17207 KUYKENDAHL RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | SPRING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773798423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8326985320 | ||||||||
| FaxNumber: | 8326985171 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 727638 | TX | Y | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 727638 | 01 | TX | RN LICENSE | OTHER |