Active NPI
Russell Alan Davidson, PHARM. D
- Pharmacist
- Kerrville, TX
National Provider Identifier
1427446285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 55200
- Practice address
- 624 Jefferson St
Kerrville, TX 78028-4506 - Phone
- (830) 795-6557
- NPI assigned
- Jan 2, 2015
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 55200 | TX | Primary |
Addresses
Primary practice location
624 Jefferson St
Kerrville, TX 78028-4506
Mailing address
114 Clear Springs Dr
Kerrville, TX 78028-7204
Phone (830) 370-6669
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 Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55200 | TX | MD | General Acute Care Hospital |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420156800000",
"number": "1427446285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 CLEAR SPRINGS DR",
"city": "KERRVILLE",
"state": "TX",
"postal_code": "780287204",
"telephone_number": "830-370-6669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "624 JEFFERSON ST",
"city": "KERRVILLE",
"state": "TX",
"postal_code": "780284506",
"telephone_number": "830-795-6557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "RUSSELL",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "PHARM. D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-01-02",
"last_updated": "2015-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "55200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kerrville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.