Individual
ROGER DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2950 E TEXAS ST STE 302, #24, BOSSIER CITY, LA 71111-3259
(318) 742-8896
(318) 742-8898
Mailing address
11103 WEST AVE, SAN ANTONIO, TX 78213-1370
(210) 524-6803
(210) 524-6587
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
636
LA
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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