Provider Demographics
NPI:1457043994
Name:DAVIS, ANDREA CELENE
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:CELENE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8310 ANACORTES ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77061-3214
Mailing Address - Country:US
Mailing Address - Phone:832-630-3078
Mailing Address - Fax:
Practice Address - Street 1:3611 ENNIS ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-4407
Practice Address - Country:US
Practice Address - Phone:832-393-5656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator