Individual
DR. BRAD RICHARD DAVIS
Active
Individual
DR. BRAD RICHARD DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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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