Healthcare Provider Details

I. General information

NPI: 1114956554
Provider Name (Legal Business Name): STEVEN L DAVIDOFF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 10/17/2022
Certification Date: 10/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6124 W PARKER RD SUITE 530
PLANO TX
75093-8122
US

IV. Provider business mailing address

6124 W PARKER RD SUITE 530
PLANO TX
75093-8122
US

V. Phone/Fax

Practice location:
  • Phone: 214-778-1075
  • Fax: 214-778-1237
Mailing address:
  • Phone: 214-778-1075
  • Fax: 214-778-1237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberM2937
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberM2937
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberM2937
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: