Active NPI
Barry Herron Davison, MD
- Pediatrics Physician
- Ennis, TX
National Provider Identifier
1356444723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- D9414
- Practice address
- 601 S Clay
Suite 103
Ennis, TX 75119 - Phone
- (972) 875-3495
- Fax
- (972) 878-0728
- NPI assigned
- Sep 7, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | D9414 | TX | Primary |
Addresses
Primary practice location
601 S Clay
Suite 103
Ennis, TX 75119
Mailing address
601 S Clay
Suite 103
Ennis, TX 75119
Phone (972) 875-3495
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00H74L | Other | TX | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D9414 | TX | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356444723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 S CLAY",
"address_2": "SUITE 103",
"city": "ENNIS",
"state": "TX",
"postal_code": "75119",
"telephone_number": "972-875-3495",
"fax_number": "972-878-0728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 S CLAY",
"address_2": "SUITE 103",
"city": "ENNIS",
"state": "TX",
"postal_code": "75119",
"telephone_number": "972-875-3495",
"fax_number": "972-878-0728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVISON",
"first_name": "BARRY",
"middle_name": "HERRON",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "D9414",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "00H74L",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ennis, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.