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General NPI Number Information
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NPI Number | 1346840352
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Entity Type | Individual
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Provider Name | ANTHONY DAVIS
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Gender | Male
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Dates
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Enumeration Date | 10/28/2020
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Last Update Date | 10/28/2020
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Provider Practice Location Address
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Address Line | 101 E REDD RD
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City | EL PASO
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State | TX
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Zip | 79932-1981
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Country | US
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Telephone | 915-206-6140
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Fax |
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Provider Business Mailing Address
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Address Line | 425 KINGSWOOD DR
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City | EL PASO
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State | TX
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Zip | 79932-2217
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 45803
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License Number State | TX
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