Organization
MDO2, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OTIS ROBERT DAVIS MD (MANAGER/ OWNER)
(972) 816-5969
Entity
Organization
Contact information
Practice address
3716 STANDRIDGE DR, THE COLONY, TX 75056-4566
(972) 816-5969
Mailing address
3217 HUNTER LN, PLANO, TX 75093-8826
(972) 816-5969
Taxonomy
Speciality
Code
Description
License number
State
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194753152
NPPES
—
Enumeration date
06/16/2020
Last updated
06/16/2020
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