Provider Demographics
NPI:1407876113
Name:DAVIS, REAHSHELL LEIGH (RT(R), RDMS, RVT)
Entity type:Individual
Prefix:MRS
First Name:REAHSHELL
Middle Name:LEIGH
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RT(R), RDMS, RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 731
Mailing Address - Street 2:
Mailing Address - City:LEAKEY
Mailing Address - State:TX
Mailing Address - Zip Code:78873-0731
Mailing Address - Country:US
Mailing Address - Phone:361-205-2230
Mailing Address - Fax:
Practice Address - Street 1:1069 SADDLE MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:RIO FRIO
Practice Address - State:TX
Practice Address - Zip Code:78879
Practice Address - Country:US
Practice Address - Phone:361-205-2230
Practice Address - Fax:361-000-0000
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3505942471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography