Individual
MR. JERRY WAYNE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2715 AVENUE N, NEDERLAND, TX 77627-7814
(409) 729-9339
Mailing address
2715 AVENUE N, NEDERLAND, TX 77627-7814
(409) 729-9339
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
565508
TX
Other
Enumeration date
07/31/2006
Last updated
07/08/2007
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