Bryan W Davis, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

L3948 Issued in TX

Practice address

129 Creekbend Blvd
Nacogdoches, TX 75965-1781

Phone

(936) 205-5949

Fax

(936) 205-5953

NPI assigned

Jul 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

University of Texas Medical School at San Antonio, 1998

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Nacogdoches Medical Center Hospital, Nacogdoches, TX, CCN 450656
• Nacogdoches Memorial Hospital Hospital, Nacogdoches, TX, CCN 450508
• CHI St Lukes Health Memorial Lufkin Hospital, Lufkin, TX, CCN 450211
• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Walk-in Clinic, LLC

  • Family Medicine Physician
  • Temple, TX
  • NPI 1033566286
  NPD (past)
• Halifax Healthcare Systems Inc

  • Family Medicine Physician
  • Daytona Beach, FL
  • NPI 1245283530
  NPD (past)
• Halifax Healthcare Systems Inc

  • Cardiovascular Disease Physician
  • Daytona Beach, FL
  • NPI 1366452591
  NPD (past)

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

• Memorial Health System of East Texas

  • Rural Acute Care Hospital
  • Lufkin, TX
  • NPI 1396746129
  Care Compare affiliation
• Mother Frances Hospital Regional Health Care Center

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Care Compare affiliation
• Nacogdoches County Hospital District

  • Rural Acute Care Hospital
  • Nacogdoches, TX
  • NPI 1801831748
  Care Compare affiliation
• TH Healthcare, LTD

  • General Acute Care Hospital
  • Nacogdoches, TX
  • NPI 1700885076
  Care Compare affiliation

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1295760080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 CREEKBEND BLVD",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651781",
            "telephone_number": "936-205-5949",
            "fax_number": "936-205-5953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 CREEKBEND BLVD",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651781",
            "telephone_number": "936-205-5949",
            "fax_number": "936-205-5953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BRYAN",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L3948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154032004",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sydney Dailey
• Daniel & Max, LLC
• Matthew David Daugherty, DPM
• David Ashley MD DMD Oral Surgery Group, a Professional Dental Corp
• David L. Duke III, MD PLLC
• Carl Alexander Davis, M.D.
• Dudley Perdue Davis Jr., DDS
• Glenn Monroe Davis, MD
• Lauren Davis, PA-C
• Marcy Franks Davis, P.T.

• Family Medicine Physician in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.

Verify at the official NPI Registry.