Davis, Larry R.

Davis, Larry R. is an individual health care provider with primary practice located at 4330 Medical Dr Ste 105 , San Antonio TX 78229-3342. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Davis, Larry R. can be contacted via phone (210) 692-7228.

Contact Information

Primary practice address
4330 Medical Dr Ste 105 San Antonio TX 78229-3342
Phone: (210) 692-7228
Fax: (210) 692-9671
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X F3888 Texas

Profile Details

NPI number 1386628998
LBN Legal business name Davis, Larry R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2005
Last updated Aug 26th, 2020 - about 5 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 1386628998 NPPES
Texas MEDICAID 102107301
Texas Other 110206520

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