Organization
WELLSPRING CV, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CORNELIUS DAVIS MD (OWNER)
(713) 714-4040
Entity
Organization
Contact information
Practice address
5373 W ALABAMA STREET, STE 204, HOUSTON, TX 77056
(713) 714-4040
(713) 588-1850
Mailing address
PO BOX 2868, BELLAIRE, TX 77402-2868
(713) 714-4040
(713) 588-1850
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165376801
—
TX
Enumeration date
08/24/2020
Last updated
08/12/2021
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