Davis, Michael L

Davis, Michael L is an individual health care provider with primary practice located at 409 Glenwood St 500, Glen Rose TX 76043-4933. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Davis, Michael L can be contacted via phone (254) 897-3369.

Contact Information

Primary practice address
409 Glenwood St 500 Glen Rose TX 76043-4933
Phone: (254) 897-3369
Fax: (254) 898-1157
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X E2532 Texas

Profile Details

NPI number 1902855265
LBN Legal business name Davis, Michael L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 6th, 2006
Last updated Jan 12th, 2017 - about 7 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 1902855265 NPPES
Texas MEDICAID 140044228

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