MEDICARE: DR. SAMUEL H 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	208000000X	Pediatrics Physician	M7134	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1851514046	OTHER	TX	TRICARE
2	8F9944	OTHER	TX	BCBS
3	8DE492	OTHER	TX	BCBS OF TEXAS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851514046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMUEL H DAVIS MD

Provider Business Mailing Address
First Line	:	P.O. BOX 961205
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76161-1205
Country	:	US
Telephone Number	:	817-740-8400
Fax Number	:

Provider Business Practice Location Address
First Line	:	604 E BAILEY BOSWELL RD STE 140
Second Line	:
City	:	SAGINAW
State	:	TX
Zip	:	76131-3568
Country	:	US
Telephone Number	:	817-484-6610
Fax Number	:	817-423-7476

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

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	06/24/2024

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Directions to “ DR. SAMUEL H DAVIS MD” Practice Location

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