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Individual

JOHN B DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 479-0019
Mailing address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 479-0019

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP112705
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
172991501
TX
01
8N7439
BCBS
TX
Enumeration date
07/20/2005
Last updated
11/20/2023
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