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NPI Code Detail

MEDICARE: JOHN B DAVIS FNP

MEDICARE: JOHN B DAVIS FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerAP112705TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18N7439OTHERTXBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457350431
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN B DAVIS FNP
Provider Business Mailing Address
First Line : 4502 MEDICAL DR
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-4402
Country : US
Telephone Number : 210-479-0019
Fax Number :
Provider Business Practice Location Address
First Line : 4502 MEDICAL DR
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-4402
Country : US
Telephone Number : 210-479-0019
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2005
Last Update Date : 11/20/2023

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