Active NPI
Dominique Davis, MD, MS
- Pediatrics Physician
- Galveston, TX
National Provider Identifier
1104576941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- V7202
- Practice address
- 400 Harborside Dr
Galveston, TX 77555-3411 - Phone
- (409) 772-3695
- Fax
- (409) 772-3680
- NPI assigned
- Mar 25, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | V7202 | TX | Primary |
Addresses
Primary practice location
400 Harborside Dr
Galveston, TX 77555-3411
Mailing address
1 Baylor PLZ # Bcm320
Houston, TX 77030-3411
Other practice location 1
1 Baylor Plz # Bcm320
Houston, TX 77030-3411
Phone (832) 824-1170
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Utmb Faculty Group Practice | Pediatrics | Current | Accepting new patients |
| University of Texas Medical Branch at Galveston | Past | Accepting new patients |
Locations
6416 Broadway St
Galveston, TX 77551
Phone (409) 744-5437
301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883
Interoperability endpoints
- ddavis416130@prddirect.texaschildrens.org
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.
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- Community/Retail Pharmacy
- Friendswood, TX
- NPI 1699532861
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748390400000",
"number": "1104576941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 BAYLOR PLZ # BCM320",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770303411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 HARBORSIDE DR",
"city": "GALVESTON",
"state": "TX",
"postal_code": "775553411",
"telephone_number": "409-772-3695",
"fax_number": "409-772-3680"
}
],
"practiceLocations": [
{
"address_1": "1 Baylor Plz # Bcm320",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770303411",
"country_code": "US",
"telephone_number": "832-824-1170",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIS",
"first_name": "DOMINIQUE",
"name_prefix": "Dr.",
"credential": "MD, MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-25",
"last_updated": "2025-05-28",
"certification_date": "2025-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "V7202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Galveston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.