Davis, Larry J

Davis, Larry J is an individual health care provider with primary practice located at 6901 Medical Parkway , Waco TX 76712. He recently has only one registered license in Other Service Providers / Legal Medicine, which is considered as his primary health care specialty. Davis, Larry J can be contacted via phone (254) 582-7481.

Contact Information

Primary practice address
6901 Medical Parkway Waco TX 76712
Phone: (254) 582-7481
Fax: (254) 582-2199
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Legal Medicine 173000000X C15087 Texas

Profile Details

NPI number 1285600668
LBN Legal business name Davis, Larry J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2006
Last updated May 29th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285600668 NPPES
Texas Other 8X5373 BLUE CROSS BLUE SHIELD
Texas MEDICAID 102739304 BLUE CROSS BLUE SHIELD
Texas MEDICAID 102739301 BLUE CROSS BLUE SHIELD

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