Individual
LANCE EDWIN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3621 HANOVER ST, DALLAS, TX 75225-7211
(214) 363-4805
Mailing address
3621 HANOVER ST, DALLAS, TX 75225-7211
(214) 363-4805
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
BP20034594
TX
Other
Enumeration date
06/22/2009
Last updated
06/22/2009
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