MEDICARE: DR. ERIC B DAVIS MD

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	174400000X	Specialist	G4957	TX

General Provider Information

NPI Number	:	1235107889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC B DAVIS MD

Provider Business Mailing Address
First Line	:	4760 SWEETWATER BLVD
Second Line	:	SUITE 104
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-3148
Country	:	US
Telephone Number	:	281-265-1100
Fax Number	:	281-265-1121

Provider Business Practice Location Address
First Line	:	4760 SWEETWATER
Second Line	:	SUITE 104
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-3845
Country	:	US
Telephone Number	:	281-265-1100
Fax Number	:	281-265-1121

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

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	11/16/2007

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