Provider Demographics
NPI:1942037270
Name:DAVIDSON, SHAY (LM)
Entity type:Individual
Prefix:
First Name:SHAY
Middle Name:
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 LARKS AIRE PL
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77381-6424
Mailing Address - Country:US
Mailing Address - Phone:303-246-0783
Mailing Address - Fax:
Practice Address - Street 1:7 LARKS AIRE PL
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77381-6424
Practice Address - Country:US
Practice Address - Phone:303-246-0783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99574176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife