Provider Demographics
NPI:1194224006
Name:DAVIS, LAUREN ASHLEY (PA)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ASHLEY
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2435 W OAK ST STE 101
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-4313
Mailing Address - Country:US
Mailing Address - Phone:940-299-4263
Mailing Address - Fax:940-535-7326
Practice Address - Street 1:2435 W OAK ST STE 101
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-4313
Practice Address - Country:US
Practice Address - Phone:940-299-4263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-06
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA11532363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical