Individual
LARRY R. DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4330 MEDICAL DR STE 105, SAN ANTONIO, TX 78229-3342
(210) 692-7228
(210) 692-9671
Mailing address
7142 SAN PEDRO AVE, SUITE 120, SAN ANTONIO, TX 78216-6256
(210) 661-5622
(210) 798-6811
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
F3888
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102107301
—
TX
01
—
110206520
MEDICARE RAILROAD
TX
Enumeration date
12/06/2005
Last updated
08/26/2020
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