Larry R. Davis, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

F3888 Issued in TX

Practice address

4330 Medical Dr Ste 105
San Antonio, TX 78229-3342

Phone

(210) 692-7228

Fax

(210) 692-9671

NPI assigned

Dec 6, 2005

Last updated

Aug 26, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sakdc - Davita Dialysis Partners LP

  dba Judson Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Antonio, TX
  • NPI 1730651100
  NPD (past)

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1386628998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7142 SAN PEDRO AVE",
            "address_2": "SUITE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166256",
            "telephone_number": "210-661-5622",
            "fax_number": "210-798-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 MEDICAL DR STE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293342",
            "telephone_number": "210-692-7228",
            "fax_number": "210-692-9671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "LARRY",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "F3888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "110206520",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102107301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth McKay Davis, MD
• Kim Shawn Davis, RN
• Krystal Lee Davis, IOM
• Lacresa B. Davis
• Lakoha Davis
• Laurie Michelle Davis, MD
• Lindsay Nicole Davis
• Lisa Anne Davis, M.D.
• Marissa Davis, BCBA
• Mark Adrian Davis, PTA

• Nephrology Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Nephrology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; 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.