# DONALD D DAVENPORT JR D O P A

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053435362
- **Authorized official:** DR. DONALD D DAVENPORT JR. D.O. (OWNER PHYSICIAN)
- **Authorized official phone:** (432) 580-8330

## Contact information

- **Practice address:** 540 W 5TH ST STE 470, ODESSA, TX 79761-5070
- **Practice address phone:** (432) 580-8330
- **Practice address fax:** (432) 580-8333
- **Mailing address:** 540 W 5TH ST STE 470, ODESSA, TX 79761-5070
- **Mailing address phone:** (432) 580-8330
- **Mailing address fax:** (432) 580-8333

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | L0118 | TX | — |
| 2086S0102X | Surgical Critical Care Physician | L0118 | TX | Yes |
| 2086S0120X | Pediatric Surgery Physician | L0118 | TX | — |
| 2086S0127X | Trauma Surgery Physician | L0118 | TX | — |
| 2086X0206X | Surgical Oncology Physician | L0118 | TX | — |
| 208C00000X | Colon & Rectal Surgery Physician | L0118 | TX | — |

## Other

- **Enumeration date:** 03/19/2007
- **Last updated:** 04/14/2008