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Individual
LARRY J DAVIS
Active
Individual
LARRY J DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
C15087
TX
207R00000X
Internal Medicine Physician
Primary
E9052
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102739301
—
TX
05
—
102739304
—
TX
01
—
8X5373
BLUE CROSS BLUE SHIELD
TX
Enumeration date
02/27/2006
Last updated
09/02/2026
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