SHANE DAVISON (NPI# 1902462500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902462500 |
| Entity Type | Individual |
| Full Name | SHANE DAVISON |
| Practice Address |
210 Lake Rd Ste 700a Lake Jackson TX 77566-4988 |
| Mailing Address |
9514 Ocean Dr Iowa Colony TX 77583-1603 |
| Practice Telephone | 9792859242 |
| Mailing Telephone | 2816301113 |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2019-06-10 |
| NPI Deactivation Date | 05/21/2019 |
| NPI Reactivation Date | 2019-06-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
78160 | TX | Behavioral Health & Social Service Providers |
| Street Address |
210 LAKE RD STE 700A |
| City | LAKE JACKSON |
| State | TX |
| Zip Code | 77566-4988 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033632971 | Gateway Consulting and Psychological Services | Psychologist | 210 Lake Rd Ste 700a, Lake Jackson, TX 77566-4988 | 2017-07-24 |
| 1396255287 | Pasito A Pasito Applied Behavior Analysis LLC | Behavioral Analyst | 210 Lake Rd Ste 700a, Lake Jackson, TX 77566-4988 | 2017-10-04 |
| 1588174577 | Elba Rohena | Behavioral Analyst | 210 Lake Rd Ste 700a, Lake Jackson, TX 77566-4988 | 2017-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588271746 | Daniel Kent | Pharmacist | 121 Tx-332 W, Lake Jackson, TX 77566 | 2020-09-30 |
| 1134692403 | Gulf Coast Gastroenterology Lab | Clinical Medical Laboratory | 219 Oak Drive South, Suite A, Lake Jackson, TX 77566 | 2019-01-09 |
| 1194266288 | Kaitlin Dingee | Nurse Practitioner | 208 Oak Dr S Ste 502, Lake Jackson, TX 77566 | 2017-03-09 |
| 1326581935 | Nec Lake Jackson Emergency Center, Lp | Clinic/Center | 103 Winding Way, Lake Jackson, TX 77566 | 2016-11-30 |
| 1548618911 | Sara Eddy | Counselor | 109 Circle Way, Lake Jackson, TX 77566 | 2016-05-26 |
| 1689020158 | Baker Chiropractic Center Pllc | Chiropractor | 100-a Plantation Drive, Lake Jackson, TX 77566 | 2016-05-13 |
| 1326409368 | Janet Chen | Pharmacist | 131 Oyster Creek Dr., Lake Jackson, TX 77566 | 2016-03-18 |
| 1164819488 | Eco Dental Care, Pllc | Dentist | 210 Lake Rd, Ste 800 A, Lake Jackson, TX 77566 | 2015-04-24 |
| 1730578196 | Anna Katherine Tucker | Occupational Therapy Assistant | 1052 Cardinal Dr, Richwood, TX 77566 | 2015-01-22 |
| 1306243035 | H-e-b, Lp | Clinical Medical Laboratory | 97 Oyster Creek Drive, Lake Jackson, TX 77566 | 2014-11-24 |
| Find all providers in zip 77566 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972112910 | Greater Clarity Counseling, LLC | Counselor | 51 Plum Ct, Lake Jackson, TX 77566-4806 | 2020-07-27 |
| 1326529066 | Michelle Langley | Counselor | 135 Oyster Creek Dr Ste I, Lake Jackson, TX 77566-4118 | 2018-08-21 |
| 1104354828 | Karen Renee Gresham | Counselor | 109 Circle Way St, Lake Jackson, TX 77566-5233 | 2017-05-25 |
| 1629514336 | Lisa Huitt | Counselor | 123 Cardinal St, Lake Jackson, TX 77566-4727 | 2017-01-19 |
| 1548618911 | Sara Eddy | Counselor | 109 Circle Way, Lake Jackson, TX 77566 | 2016-05-26 |
| 1639561087 | Nicholas Shawver | Counselor | 202 Persimmon Ln, Lake Jackson, TX 77566-4724 | 2015-02-23 |
| 1821116013 | Josie Mueller | Counselor | 110 Heather Ln, Suite 101, Lake Jackson, TX 77566-6216 | 2007-03-26 |
| 1508910852 | Leonard Duane Alcorn | Counselor | 310 Flag Lake Drive, Lake Jackson, TX 77566 | 2007-01-23 |
| 1730230178 | Sandra Ana Alvarez | Counselor | 129 Circle Way St Ste 108, Lake Jackson, TX 77566-5239 | 2007-01-14 |
| 1851792014 | Mario Guel | Counselor | 56 Flag Lake Plz, Lake Jackson, TX 77566-6263 | 2014-09-08 |
| Find all providers in LAKE JACKSON | ||||
| City | LAKE JACKSON |
| Zip Code | 77566 |
Please comment or provide details below to improve the information on SHANE DAVISON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.