Provider Demographics
NPI:1306519483
Name:HULSE, DAVON
Entity type:Individual
Prefix:DR
First Name:DAVON
Middle Name:
Last Name:HULSE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2915 N NORTHWEST DR
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-1713
Mailing Address - Country:US
Mailing Address - Phone:575-942-5967
Mailing Address - Fax:
Practice Address - Street 1:5702 MCPHERSON RD STE 15
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6884
Practice Address - Country:US
Practice Address - Phone:956-726-4442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist