Individual
TERRY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
6170 N DURANGO DR STE 120, LAS VEGAS, NV 89149-3923
(702) 430-5333
(702) 430-5335
Mailing address
9097 W POST RD, STE 100, LAS VEGAS, NV 89148-2417
(702) 430-5333
(702) 430-5335
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
584
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00377724
RAILROAD MEDICARE
NV
Enumeration date
07/24/2006
Last updated
09/14/2020
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