Provider Demographics
NPI:1992102792
Name:DAVISON, SAWYER
Entity type:Individual
Prefix:MRS
First Name:SAWYER
Middle Name:
Last Name:DAVISON
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 1:3813 WHISPER HOLLOW WAY
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76137-7070
Mailing Address - Country:US
Mailing Address - Phone:432-349-6656
Mailing Address - Fax:
Practice Address - Street 1:3720 N JOSEY LN
Practice Address - Street 2:#104
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-2481
Practice Address - Country:US
Practice Address - Phone:972-394-7170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-24
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1223937225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist