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General NPI Number Information
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NPI Number | 1073748299
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Entity Type | Organization
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Legal Business Name | MICHAEL A. DAVIS, PC
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Dates
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Enumeration Date | 05/18/2009
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Last Update Date | 05/18/2009
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Provider Practice Location Address
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Address Line | 3019 SOUTH FWY
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City | FORT WORTH
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State | TX
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Zip | 76104-7234
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Country | US
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Telephone | 817-926-5800
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Fax | 817-926-5908
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Provider Business Mailing Address
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Address Line | 5512 RENDON NEW HOPE RD
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City | FORT WORTH
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State | TX
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Zip | 76140-8110
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Country | US
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Telephone | 817-808-1076
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Fax | 817-483-5200
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. MICHAEL A DAVIS
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Credential | D.C.
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Telephone | 817-808-1076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 6423
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License Number State | TX
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