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NPI Code Detail

MEDICARE: JOHN W. DAVIS M.D.

MEDICARE: JOHN W. DAVIS 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
1208800000XUrology Physician0101053580VA
2208800000XUrology PhysicianL0785TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1460749OTHERVAANTHEM BC BS
258216OTHERVASENTARA HEALTHCARE
38B5923OTHERTXBLUE SHIELD
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740268978
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN W. DAVIS M.D.
Provider Business Mailing Address
First Line : PO BOX 4439
Second Line :
City : HOUSTON
State : TX
Zip : 77210-4439
Country : US
Telephone Number : 713-792-2991
Fax Number :
Provider Business Practice Location Address
First Line : 1515 HOLCOMBE BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77030-4009
Country : US
Telephone Number : 713-792-6161
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2006
Last Update Date : 11/11/2011

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