Individual
DR. GLENN R DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2255 E MOSSY OAKS RD STE 680, SPRING, TX 77389-1812
(281) 537-0300
(281) 537-0315
Mailing address
2255 E MOSSY OAKS RD STE 680, SPRING, TX 77389-1812
(281) 537-0300
(281) 537-0315
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
38899
OK
207R00000X
Internal Medicine Physician
Primary
K5503
TX
208000000X
Pediatrics Physician
K5503
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110240334
MEDICARE RAILROAD PIN
TX
Enumeration date
10/26/2005
Last updated
10/17/2022
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