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General NPI Number Information
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NPI Number | 1326154147
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Entity Type | Individual
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Provider Name | MARK HUDSON DAVIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 04/13/2015
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Provider Practice Location Address
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Address Line | 10655 STEEPLETOP DR
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City | HOUSTON
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State | TX
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Zip | 77065-4222
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Country | US
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Telephone | 281-517-9102
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Fax |
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Provider Business Mailing Address
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Address Line | 225 DUPERIER AVE
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City | NEW IBERIA
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State | LA
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Zip | 70563-2417
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Country | US
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Telephone | 337-519-3353
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD.12888R
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License Number State | LA
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