NPIMap

Organization Active NPI

Michael L. Davis, M.D. P.a.

  • Family Medicine Physician
  • Glen Rose, TX
National Provider Identifier
1194985325
Registry record updated Jun 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E2532 Issued in TX
Legal business name
MICHAEL L. DAVIS, M.D. P.A.
Practice address
409 Glenwood St Ste 500
Glen Rose, TX 76043-4933
Phone
(254) 897-3369
NPI assigned
Jun 11, 2008
Last updated
Jun 25, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2009

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

Authorized official

Name
Dr. Michael L Davis, M.D.NPI 1902855265
Title
Owner
Phone
(254) 897-3369

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X E2532 TX Primary

Addresses

Primary practice location

409 Glenwood St Ste 500
Glen Rose, TX 76043-4933

Mailing address

PO Box 1309
Glen Rose, TX 76043-1309
Phone (254) 897-3369

National Provider Directory

National Provider Directory

Locations

409 Glenwood St
Ste 500
Glen Rose, TX 76043
Phone (254) 897-2202

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245888000000",
    "number": "1194985325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1309",
            "city": "GLEN ROSE",
            "state": "TX",
            "postal_code": "760431309",
            "telephone_number": "254-897-3369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 GLENWOOD ST STE 500",
            "city": "GLEN ROSE",
            "state": "TX",
            "postal_code": "760434933",
            "telephone_number": "254-897-3369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL L. DAVIS, M.D. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-11",
        "last_updated": "2009-06-25",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "254-897-3369",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "E2532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Rose, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.