Provider Demographics
NPI:1053583971
Name:DAVIS, JILL KATHERINE (AUD)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:KATHERINE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:KATHERINE
Other - Last Name:DAVISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3811 BEE CAVES RD STE 101
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5398
Mailing Address - Country:US
Mailing Address - Phone:512-443-3500
Mailing Address - Fax:512-291-2450
Practice Address - Street 1:3811 BEE CAVES RD STE 101
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-443-3500
Practice Address - Fax:512-291-2450
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-01
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80182231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist