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Individual

JOHN W. DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
0101053580
VA
208800000X
Urology Physician
Primary
L0785
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007504420
VA
05
146022201
TX
01
460749
ANTHEM BC BS
VA
01
58216
SENTARA HEALTHCARE
VA
01
8B5923
BLUE SHIELD
TX
Enumeration date
01/06/2006
Last updated
11/11/2011
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