MEDICARE: DR. ANGELA MARIA 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	207N00000X	Dermatology Physician	K8106	TX
2	207N00000X	Dermatology Physician	01045265A	IN

General Provider Information

NPI Number	:	1487672754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANGELA MARIA DAVIS MD

Provider Business Mailing Address
First Line	:	11511 SHADOW CREEK PKWY
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-7298
Country	:	US
Telephone Number	:	713-442-4997
Fax Number	:

Provider Business Practice Location Address
First Line	:	1235 LAKE POINTE PKWY STE 200
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-4077
Country	:	US
Telephone Number	:	281-980-0166
Fax Number	:	281-980-0177

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	03/07/2022

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