MEDICARE: DR. DAVID DAVIS D.C.

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	111N00000X	Chiropractor	12774	TX

General Provider Information

NPI Number	:	1467857656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID DAVIS D.C.

Provider Business Mailing Address
First Line	:	PO BOX 1038
Second Line	:
City	:	SANTA FE
State	:	TX
Zip	:	77510-1038
Country	:	US
Telephone Number	:	281-728-2109
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 INVINCIBLE CIR STE B
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-2956
Country	:	US
Telephone Number	:	281-334-1196
Fax Number	:

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

Provider Enumeration Date	:	10/30/2014
Last Update Date	:	11/26/2014

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