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Individual

DR. SCOTT DAVID DAVIDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1600 W COLLEGE ST, SUITE 140, GRAPEVINE, TX 76051-3580
(214) 826-6021
(214) 853-9415
Mailing address
3600 GASTON AVE, SUITE 1205, DALLAS, TX 75246-1800
(214) 692-8262
(214) 696-4190

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
L0783
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
164661402
TX
01
164661403
RRMCR
TX
05
164661403
TX
05
164661404
TX
Enumeration date
07/07/2006
Last updated
01/31/2017
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