Individual
BRYAN W DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
129 CREEKBEND BLVD, NACOGDOCHES, TX 75965-1781
(936) 205-5949
(936) 205-5953
Mailing address
129 CREEKBEND BLVD, NACOGDOCHES, TX 75965-1781
(936) 205-5949
(936) 205-5953
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L3948
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154032004
—
TX
Enumeration date
07/11/2006
Last updated
10/07/2014
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