Active NPI
Samuel V. Davila, M.D.
- Internal Medicine Physician
- Fort Worth, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- M8621
- Practice address
- 5450 Clearfork Main St Ste 300
Fort Worth, TX 76109-3559 - Phone
- (817) 334-1400
- Fax
- (817) 334-1410
- NPI assigned
- May 22, 2007
- Last updated
- Oct 23, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | M8621 | TX | Primary |
Addresses
Primary practice location
5450 Clearfork Main St Ste 300
Fort Worth, TX 76109-3559
Mailing address
5450 Clearfork Main St Ste 300
Fort Worth, TX 76109-3559
Phone (817) 334-1400
Other practice location 1
800 5th Ave
Ste. 300
Fort Worth, TX 76104-7300
Phone (817) 334-1400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34563201 | Medicaid | TX |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- University of Texas Southwestern Medical School at Dallas, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1412 May St
Fort Worth, TX 76104-7639
Phone (817) 625-8818
809 W Randol Mill Rd
Arlington, TX 76012-2507
Phone (817) 460-0257
900 Airport Fwy
Suite 158
Hurst, TX 76054-3253
Phone (817) 514-4000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M8621 | TX | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Clinic of North Texas, PLLC | Internal Medicine | Current | Accepting new patients |
| Medical Clinic of North Texas PLLC | Current | Accepting new patients |
Locations
809 W Randol Mill Rd
Arlington, TX 76012
Phone (817) 277-7133
5450 Clearfork Main St
Ste 300
Fort Worth, TX 76109
Phone (817) 334-1400
1412 May St
Ft Worth, TX 76104
Phone (817) 625-8818
800 5th Ave
Ste 300
Ft Worth, TX 76104
Phone (817) 334-1400
900 Airport Fwy
Ste 158
Hurst, TX 76054
Phone (817) 514-4000
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- samuel.davila@wellmed.eclinicaldirectplus.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba USMD Physician Services
- Internal Medicine Physician
- Arlington, TX
- NPI 1033167234
-
- Radiation Oncology Clinic/Center
- Arlington, TX
- NPI 1184131625
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fort Worth, TX
- NPI 1336172105
-
- General Acute Care Hospital
- Fort Worth, TX
- NPI 1417980202
-
dba Medical City Weatherford
- General Acute Care Hospital
- Weatherford, TX
- NPI 1417471467
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571788800000",
"number": "1023227063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5450 CLEARFORK MAIN ST STE 300",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761093559",
"telephone_number": "817-334-1400",
"fax_number": "817-334-1410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5450 CLEARFORK MAIN ST STE 300",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761093559",
"telephone_number": "817-334-1400",
"fax_number": "817-334-1410"
}
],
"practiceLocations": [
{
"address_1": "800 5th Ave",
"address_2": "Ste. 300",
"address_purpose": "LOCATION",
"city": "Fort Worth",
"state": "TX",
"postal_code": "761047300",
"country_code": "US",
"telephone_number": "817-334-1400",
"fax_number": "817-334-1410",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVILA",
"first_name": "SAMUEL",
"middle_name": "V.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2019-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "M8621",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34563201",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.