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General NPI Number Information
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NPI Number | 1861850620
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Entity Type | Individual
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Provider Name | DR. DWANE DAVIS JR.
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Gender | Male
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Dates
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Enumeration Date | 02/08/2016
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Last Update Date | 01/05/2022
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Provider Practice Location Address
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Address Line | 1225 NORTH LOOP W STE 1010
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City | HOUSTON
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State | TX
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Zip | 77008-4722
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Country | US
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Telephone | 832-586-7183
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Fax |
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Provider Business Mailing Address
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Address Line | 4305 GLENWOOD AVE APT 1003
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City | DEER PARK
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State | TX
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Zip | 77536-5779
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Country | US
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Telephone | 832-556-3652
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 13115
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License Number State | TX
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