SANDRA DAVIS MD, PA
Ambulatory Health at Mesa Springs Dr, Fort Worth, TX

License number
Texas L0120
Category
Ambulatory Health
Type
Adult Mental Health
Owner
Name: DR. SANDRA E DAVIS MD
Title: OWNER
Phone: (891) 783-2663
Address
Address
5560 Mesa Springs Dr, Fort Worth, TX 76123
National Provider ID: 1871851527
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about SANDRA DAVIS MD, PA at bizstanding.com

SANDRA DAVIS M.D., PA

Fort Worth, TX

Industry:
Medical Doctor's Office
Doing business as:
Sandra Davis M D P A
Registration:
Jan 16, 2003
Addresses:
5029 Highland Mdw Dr, Fort Worth, TX 76132 (Mailing)
6410 SW Blvd, Fort Worth, TX 76109
State ID:
0800166219
Principals:
Sandra E. Davis (Medical Doctor, Owner),Jennifer Heath (Principal)
Agent:
Sandra Davis,5029 Highland Mdw, Fort Worth, TX 76132 (Physical)
TIN:
32037844936

SANDRA DAVIS M.D., PA

Fort Worth, TX

Status:
Inactive
Doing business as:
Sandra Davis M.D., PA
Registration:
Jan 16, 2003
Addresses:
5029 Highland Mdw Dr, Fort Worth, TX 76132 (Mailing)
6410 SW Blvd, Fort Worth, TX 76109
State ID:
0800166219
Business type:
Professional Association
Member , Vice-Presidents:
Sandra E. Davis President, Director, Member, inactive,William K. Davis Member , Vice-President, inactive
Agent:
Sandra Davis,5029 Highland Mdw, Fort Worth, TX 76132 (Physical)
TIN:
32037844936

Ambulatory Health licenses in Texas










Other Doctors licenses in Texas