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General NPI Number Information
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NPI Number | 1578790473
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Entity Type | Individual
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Provider Name | BRYAN MARK DAVIS D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/18/2009
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Last Update Date | 07/08/2020
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Provider Practice Location Address
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Address Line | 230 MESA VERDE DR.
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City | CENTER POINT
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State | TX
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Zip | 78010
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Country | US
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Telephone | 830-634-2212
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Fax | 830-634-7820
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Provider Business Mailing Address
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Address Line | P.O BOX 1205
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City | CENTER POINT
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State | TX
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Zip | 78010
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Country | US
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Telephone | 830-285-7881
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Fax | 602-323-3496
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5634
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | N7611
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License Number State | TX
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