Individual
DR. DONALD D DAVENPORT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
540 W 5TH ST, STE 470, ODESSA, TX 79761-5070
(432) 580-8330
Mailing address
540 W 5TH ST STE 470, ODESSA, TX 79761-5070
(432) 580-8330
(432) 580-8333
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
L0118
TX
2086S0102X
Surgical Critical Care Physician
L0118
TX
2086S0120X
Pediatric Surgery Physician
L0118
TX
2086S0127X
Trauma Surgery Physician
L0118
TX
2086X0206X
Surgical Oncology Physician
L0118
TX
208C00000X
Colon & Rectal Surgery Physician
L0118
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8F0641
BLUE CROSS PRIVIDER #
TX
Enumeration date
06/08/2005
Last updated
10/11/2007
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