Provider Demographics
NPI:1982132445
Name:BYRD, ALEXA DAVIS (AUDIOLOGIST)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:DAVIS
Last Name:BYRD
Suffix:
Gender:F
Credentials:AUDIOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5128 OLD HIGHWAY 11 STE 8
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-6234
Mailing Address - Country:US
Mailing Address - Phone:601-450-0280
Mailing Address - Fax:601-450-0282
Practice Address - Street 1:5128 OLD HIGHWAY 11 STE 8
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-6234
Practice Address - Country:US
Practice Address - Phone:601-450-0280
Practice Address - Fax:601-450-0282
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80837231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist