Individual
GARY L. DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3410 WORTH STREET, SUITE 860, DALLAS, TX 75246
(214) 820-8500
(214) 820-8168
Mailing address
201 S OCEAN GRANDE DR, SUITE PH4, PONTE VEDRA BEACH, FL 32082-6515
(214) 783-2563
(214) 820-8168
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
L4323
TX
207RI0008X
Hepatology Physician
Primary
L4323
TX
207RT0003X
Transplant Hepatology Physician
L4323
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
157390901
—
TX
05
—
157390902
—
TX
01
—
8G0555
BCBS
TX
Enumeration date
05/31/2006
Last updated
07/03/2014
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