Carl T Davidson Jr DC PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4220 Issued in TX

Legal business name

CARL T DAVIDSON JR DC PA

Practice address

1319 W 22ND St
Odessa, TX 79763-2406

Phone

(432) 332-7882

Fax

(432) 332-2446

NPI assigned

Oct 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Carl T Davidson Jr.NPI 1477641785

Title

President/Owner

Phone

(432) 332-7882

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• WEST ODESSA CHIROPRACTIC CLINIC Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carl T Davidson Jr., D.C.

  • Chiropractor
  • Odessa, TX
  • NPI 1477641785
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578614400000",
    "number": "1043396526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 W 22ND ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797632406",
            "telephone_number": "432-332-7882",
            "fax_number": "432-332-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 W 22ND ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797632406",
            "telephone_number": "432-332-7882",
            "fax_number": "432-332-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARL T DAVIDSON JR DC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "432-332-7882",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "4220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "601581",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WEST ODESSA CHIROPRACTIC CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WEST ODESSA CHIROPRACTIC CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in Odessa, TX
• Providers in Odessa, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.