Individual
DR. NELSON ANTHONY DAVINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1517 THOMPSON RD, RICHMOND, TX 77469-4932
(281) 344-1715
(281) 344-1716
Mailing address
909 FROSTWOOD DR, SUITE 1.100, HOUSTON, TX 77024-2301
(281) 344-1715
Taxonomy
Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
G8817
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139804221
—
TX
05
—
139804222
—
TX
05
—
139804223
—
TX
05
—
139804224
—
TX
05
—
139804225
—
TX
01
—
2989737
AETNA HMO
TX
01
—
34291
AMERIGROUP
TX
01
—
4654875
AETNA PPO
TX
01
—
760505966
TAX ID
TX
01
—
8G9740
BLUE CROSS BLUE SHIELD
TX
01
—
G8817
STATE LICENSE
TX
Enumeration date
06/22/2005
Last updated
04/09/2012
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