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1376549626

NPI Code Detail

MEDICARE: DR. NELSON ANTHONY DAVINO M.D

MEDICARE: DR. NELSON ANTHONY DAVINO M.D

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	207XP3100X	Pediatric Orthopaedic Surgery Physician	G8817	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2989737	OTHER	TX	AETNA HMO
2	8G9740	OTHER	TX	BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	760505966	OTHER	TX	TAX ID
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	4654875	OTHER	TX	AETNA PPO
10	G8817	OTHER	TX	STATE LICENSE
11	34291	OTHER	TX	AMERIGROUP

General Provider Information

NPI Number	:	1376549626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NELSON ANTHONY DAVINO M.D

Provider Business Mailing Address
First Line	:	909 FROSTWOOD DR
Second Line	:	SUITE 1.100
City	:	HOUSTON
State	:	TX
Zip	:	77024-2301
Country	:	US
Telephone Number	:	281-344-1715
Fax Number	:

Provider Business Practice Location Address
First Line	:	1517 THOMPSON RD
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-4932
Country	:	US
Telephone Number	:	281-344-1715
Fax Number	:	281-344-1716

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	04/09/2012

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Directions to “ DR. NELSON ANTHONY DAVINO M.D” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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