MEDICARE: DR. SAM SPIKER DAVIS D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	10386	TX

General Provider Information

NPI Number	:	1063514982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAM SPIKER DAVIS D.D.S.

Provider Business Mailing Address
First Line	:	1220 AUGUSTA DR
Second Line	:	SUITE 200
City	:	HOUSTON
State	:	TX
Zip	:	77057-2261
Country	:	US
Telephone Number	:	713-781-2800
Fax Number	:	713-781-5641

Provider Business Practice Location Address
First Line	:	7575 SAN FELIPE ST
Second Line	:	SUITE 135
City	:	HOUSTON
State	:	TX
Zip	:	77063-1711
Country	:	US
Telephone Number	:	713-781-2800
Fax Number	:	713-783-2910

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	01/23/2009

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