Active NPI
Robert Davidson, M.D.
- Internal Medicine Physician
- Gladewater, TX
National Provider Identifier
1497869804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- H2328
- Practice address
- 307 W Upshur Ave
Gladewater, TX 75647-2121 - Phone
- (903) 845-2159
- Fax
- (903) 845-5451
- NPI assigned
- Aug 19, 2006
- Last updated
- Feb 19, 2008
- 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 | H2328 | TX | Primary |
Addresses
Primary practice location
307 W Upshur Ave
Gladewater, TX 75647-2121
Mailing address
4002 Technology Ctr
Longview, TX 75605-2697
Phone (903) 247-0484
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H2328 | TX | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Texas Treatment Center | Past | Accepting new patients | |
| Phynet, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Kilgore, TX
- NPI 1023002425
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203379200000",
"number": "1497869804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4002 TECHNOLOGY CTR",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756052697",
"telephone_number": "903-247-0484",
"fax_number": "903-247-0485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "307 W UPSHUR AVE",
"city": "GLADEWATER",
"state": "TX",
"postal_code": "756472121",
"telephone_number": "903-845-2159",
"fax_number": "903-845-5451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-19",
"last_updated": "2008-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "H2328",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gladewater, TX
- Collect Memories at Home LLC
- Jordan Davis Corpier, RN
- Angela Brooke Cox, D.C.
- CVS Pharmacy Inc (CVS Pharmacy #07444)
- Augusta Helene Daughtry
- Easttexrx LLC (Walker Pharmacy)
- Errands for All, LLC (Errands for All)
- Kathleen Michelle Eudy, LVN
- Sharon Evers, M.D.
- Fannin County Hospital Authority (Legend Oaks Healthcare and Rehabilitation Center Gladewater)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.