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General NPI Number Information
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NPI Number | 1548142573
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Entity Type | Individual
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Provider Name | DONALD BRADSHAW DAVIS AGPCNP-BC
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Gender | Male
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Dates
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Enumeration Date | 07/22/2025
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 11110 EAST FWY # 100
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City | JACINTO CITY
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State | TX
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Zip | 77029-1914
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Country | US
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Telephone | 713-330-0766
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Fax |
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Provider Business Mailing Address
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Address Line | 15 MAPLE BRANCH ST
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City | SPRING
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State | TX
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Zip | 77380-1894
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Country | US
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Telephone | 832-557-0507
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 1022569
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License Number State | TX
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