Individual provider Active NPI

Jacqueline Leticia Davis-Herr, MD

  • Obstetrics & Gynecology Physician
  • Flower Mound, TX
National Provider Identifier
1003862715
Registry record updated Sep 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
M0700 Issued in TX
Practice address
4001 Long Prairie Rd
Suite 150
Flower Mound, TX 75028-1565
Phone
(972) 420-1470
Fax
(972) 420-1465
NPI assigned
May 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X M0700 TX Primary

Addresses

Primary practice location

4001 Long Prairie Rd
Suite 150
Flower Mound, TX 75028-1565

Mailing address

4001 Long Prairie Rd
Suite 150
Flower Mound, TX 75028-1565
Phone (972) 420-1470

Other identifiers 1

IdentifierTypeStateIssuer
182734701MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060925000597 TX Practitioner - Obstetrics/Gynecology 7012912066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Texas Tech University Health Science Center School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4001 Long Prairie Rd
Suite 150
Flower Mound, TX 75028-1535
Phone (972) 420-1470

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M0700TXMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lewisville Obstetrics & Gynecology Associates. P.a. Obstetrics & Gynecology CurrentSince Aug 28, 2006 Accepting new patients
Lewisville Obstetrics & Gynecology Associates, PA CurrentSince Aug 28, 2006 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441929600000",
    "number": "1003862715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 LONG PRAIRIE RD",
            "address_2": "SUITE 150",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750281565",
            "telephone_number": "972-420-1470",
            "fax_number": "972-420-1465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 LONG PRAIRIE RD",
            "address_2": "SUITE 150",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750281565",
            "telephone_number": "972-420-1470",
            "fax_number": "972-420-1465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS-HERR",
        "first_name": "JACQUELINE",
        "middle_name": "LETICIA",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2015-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "M0700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182734701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flower Mound, TX

Sources for this page

Verify at the official NPI Registry.