Provider Demographics
NPI:1538307764
Name:DAVIS, KIMBERLY ANNE (DC, ART)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:ANNE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DC, ART
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 W BRAKER LN BLDG 2-300
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-7854
Mailing Address - Country:US
Mailing Address - Phone:512-266-1000
Mailing Address - Fax:512-597-0898
Practice Address - Street 1:2305 DONLEY DR STE 106
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-4535
Practice Address - Country:US
Practice Address - Phone:512-266-1000
Practice Address - Fax:512-597-0898
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-26
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8980111NR0400X
TX12008111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty