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General NPI Number Information
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NPI Number | 1164793139
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Entity Type | Organization
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Legal Business Name | WILLIAM M. DAVIS, M.D., P.A.
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Dates
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Enumeration Date | 01/23/2012
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Last Update Date | 01/23/2012
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Provider Practice Location Address
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Address Line | 3705 MEDICAL PKWY. SUITE 510
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City | AUSTIN
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State | TX
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Zip | 78705-1024
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Country | US
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Telephone | 512-454-6723
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Fax | 512-459-4412
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Provider Business Mailing Address
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Address Line | 3705 MEDICAL PARKWAY SUITE 510
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City | AUSTIN
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State | TX
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Zip | 78705-1024
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Country | US
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Telephone | 512-454-6723
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Fax | 512-459-4412
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM M. DAVIS
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Credential | M.D.
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Telephone | 512-454-6723
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | D5957
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License Number State | TX
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