Organization
PATRICK DAVIS PA-C LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK DAVIS PAC (OWNER)
(702) 604-7422
Entity
Organization
Contact information
Practice address
724 KENDALL LN, BOULDER CITY, NV 89005-1112
(702) 604-7422
(908) 345-8788
Mailing address
PO BOX 752287, LAS VEGAS, NV 89136-2287
(702) 604-7422
(908) 345-8788
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA823
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NV20091190921
NV SOS BUSINESS LICENSE
NV
Enumeration date
05/18/2012
Last updated
10/22/2019
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