Individual
DR. BRAD RICHARD DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
801 E PLANO PKWY, SUITE 100, PLANO, TX 75074-6746
(972) 422-5941
(972) 881-4390
Mailing address
801 E PLANO PKWY, SUITE 100, PLANO, TX 75074-6746
(972) 422-5941
(972) 881-4390
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
L7704
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166819601
—
TX
05
—
166819602
—
TX
05
—
166819603
—
TX
05
—
166819604
—
TX
05
—
166819605
—
TX
01
—
166819606
MEDICAID CSHCN
TX
01
—
166819607
MEDICAID CSHCN
TX
01
—
166819608
MEDICAID CSHCN
TX
01
—
8M8930
BCBS
TX
Enumeration date
12/29/2005
Last updated
04/03/2015
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