Provider Demographics
NPI:1174938609
Name:DAVIES, TABITHA (DO)
Entity type:Individual
Prefix:DR
First Name:TABITHA
Middle Name:
Last Name:DAVIES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MRS
Other - First Name:TABITHA
Other - Middle Name:ANN
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:540 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:HEREFORD
Mailing Address - State:TX
Mailing Address - Zip Code:79045-2820
Mailing Address - Country:US
Mailing Address - Phone:806-364-2141
Mailing Address - Fax:844-742-8369
Practice Address - Street 1:540 W 15TH ST
Practice Address - Street 2:
Practice Address - City:HEREFORD
Practice Address - State:TX
Practice Address - Zip Code:79045-2820
Practice Address - Country:US
Practice Address - Phone:806-364-7512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-23
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS6602207V00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty