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Organization
WELLSPRING CARDIOVASCULAR & THORACIC SURGERY, PA
Active
Organization
WELLSPRING CARDIOVASCULAR & THORACIC SURGERY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CORNELIUS ALEXANDER DAVIS III M.D. (OWNER)
(713) 795-4545
Entity
Organization
Contact information
Practice address
6400 FANNIN ST, STE. 2500, HOUSTON, TX 77030-1521
(713) 795-4545
(713) 795-4595
Mailing address
PO BOX 20056, HOUSTON, TX 77225-0056
(713) 795-4545
(713) 795-4595
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
L7349
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528037975
INDIVIDUAL NPI
TX
05
—
1653768-01
—
TX
Enumeration date
10/23/2007
Last updated
10/24/2011
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