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Chandra Lyn Davenport, PA-C
Medical Physician Assistant in Dallas, Texas
NPI 1194810622

Chandra Lyn Davenport is a Medical Physician Assistant based in Dallas, TX and is specialized in Medical. Chandra Lyn Davenport practices in Dallas, TX and has the professional credentials of PA-C. The NPI Number for Chandra Lyn Davenport is 1194810622 and holds a License No. PA04620 (Texas).

The current practice location address for Chandra Lyn Davenport is 12221 Merit Dr, Dallas, TX and can be reached out via phone at 972-372-0912 and via fax at 214-217-1901.

Location: 12221 Merit Dr, Dallas, TX, 75251-2202
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1194810622
Provider Name
Chandra Lyn Davenport
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
12221 Merit Dr, Dallas, TX, 75251-2202
Phone Number
972-372-0912
Fax Number
214-217-1901
Provider Enumeration Date
10/03/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
3010613-01 05 TX
institution
Provider Business Practice Location Address Details
Address
12221 Merit Dr
City
Dallas
State
Texas
Zip
75251-2202
Phone Number
972-372-0912
Fax Number
214-217-1901
person
Provider Business Mailing Address Details
Address
12221 Merit Dr
City
Dallas
State
Texas
Zip
75251-2202
Phone Number
972-372-0912
Fax Number
214-217-1901
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
PA04620 (Texas)
Definition
Definition to come...
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