MEDICARE: DAVID GARLAND DAVIS MD

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
1	207X00000X	Orthopaedic Surgery Physician	TX E-0875	TX
2	207XS0106X	Orthopaedic Hand Surgery Physician	TX E-0875	TX
3	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	TX E-0875	TX
4	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	TX E-0875	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	TX E-0875	OTHER	TX	MEDICAL LICENSE

General Provider Information

NPI Number	:	1871591354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID GARLAND DAVIS MD

Provider Business Mailing Address
First Line	:	11623 ANGUS RD
Second Line	:	SUITE 15
City	:	AUSTIN
State	:	TX
Zip	:	78759-4003
Country	:	US
Telephone Number	:	512-346-7170
Fax Number	:

Provider Business Practice Location Address
First Line	:	11623 ANGUS RD
Second Line	:	SUITE 15
City	:	AUSTIN
State	:	TX
Zip	:	78759-4003
Country	:	US
Telephone Number	:	512-346-7170
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	11/12/2008

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