MEDICARE: DR. RYAN R DAVIES 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	208600000X	Surgery Physician	231289	NY
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	231289	NY
3	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	A110460	CA
4	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	C10009649	DE
5	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	R3497	TX

General Provider Information

NPI Number	:	1780688291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RYAN R DAVIES MD

Provider Business Mailing Address
First Line	:	1935 MEDICAL DISTRICT DR,
Second Line	:	MC B3.410
City	:	DALLAS
State	:	TX
Zip	:	75235-7701
Country	:	US
Telephone Number	:	214-456-5000
Fax Number	:	302-456-5015

Provider Business Practice Location Address
First Line	:	1935 MEDICAL DISTRICT DR # MCB3.410
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-7701
Country	:	US
Telephone Number	:	214-456-5000
Fax Number	:	214-456-5015

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

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	12/04/2017

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Directions to “ DR. RYAN R DAVIES MD” Practice Location

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