Individual
DR. MAYLI L DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6208 COLLEYVILLE BOULEVARD, SUITE 100, COLLEYVILLE, TX 76034-6228
(817) 329-4480
(817) 488-5993
Mailing address
6208 COLLEYVILLE BOULEVARD, SUITE 100, COLLEYVILLE, TX 76034-6228
(817) 329-4480
(817) 488-5993
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
J5739
TX
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
J5739
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0067EZ
BCBS GROUP NUMBER
TX
05
—
10022132
—
TX
05
—
127504201
—
TX
01
—
3344906
BCBS BLUE LINK NUMBER
TX
01
—
4589684
AETNA
TX
01
—
8A6670
BCBS INDIVIDUAL NUMBER
TX
Enumeration date
11/29/2005
Last updated
06/14/2021
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