Active NPI
William Davis, MD
- Internal Medicine Physician
- Odessa, TX
National Provider Identifier
1447282645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- E6060
- Practice address
- 701 W 5TH St
Attn Credentialing
Odessa, TX 79763-4206 - Phone
- (432) 335-5250
- Fax
- (432) 335-5262
- NPI assigned
- Jul 7, 2006
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | E6060 | TX | Primary |
Addresses
Primary practice location
701 W 5TH St
Attn Credentialing
Odessa, TX 79763-4206
Mailing address
701 W 5TH St
Attn Credentialing
Odessa, TX 79763-4206
Phone (432) 335-5250
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100170920A | Medicaid | OK | |
| 24881 | Medicaid | NM | |
| 132236401 | Medicaid | TX |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wyatt Clinic, P.a. | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319068800000",
"number": "1447282645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 W 5TH ST",
"address_2": "ATTN CREDENTIALING",
"city": "ODESSA",
"state": "TX",
"postal_code": "797634206",
"telephone_number": "432-335-5250",
"fax_number": "432-335-5262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 W 5TH ST",
"address_2": "ATTN CREDENTIALING",
"city": "ODESSA",
"state": "TX",
"postal_code": "797634206",
"telephone_number": "432-335-5250",
"fax_number": "432-335-5262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "WILLIAM",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2011-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "E6060",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100170920A",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "24881",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "132236401",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Odessa, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.