Individual provider · Type 1 NPI

Staci Lynn Davenport, MD

Student in an Organized Health Care Education/Training Program · Fort Worth, TX

NPI number 1295147007 Active

Practice location

1500 S Main St, Fhc, 4th Floor
Fort Worth, TX 76104-4917

Call (817) 702-1215 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1295147007

Staci Lynn Davenport, MD's National Provider Identifier is 1295147007, issued on May 28, 2014. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Fort Worth, TX. The record was last updated on May 28, 2014.