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Organization
SAMUEL H. DAVIS MD PA
Active
Organization
SAMUEL H. DAVIS MD PA
Active
Other names
Child Plus Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEAN A. DELAWTER MHA (CEO/SENIOR PARTNER-ON-SITE-MEDICAL)
(940) 484-6500
Entity
Organization
Contact information
Practice address
604 E. BAILEY BOSWELL, SUITE 140, SAGINAW, TX 76131
(817) 484-6610
(817) 423-7476
Mailing address
3205 MEDPARK DRIVE, DENTON, TX 76208-6932
(940) 484-6500
(800) 481-0150
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M7134
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396010096
TRICARE
TX
Enumeration date
03/13/2012
Last updated
08/09/2012
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