Individual provider Active NPI

Cornelius Alexander Davis III, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Houston, TX
National Provider Identifier
1528037975
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
L7349 Issued in TX
Practice address
5373 W Alabama Street
Ste 204
Houston, TX 77056
Phone
(713) 714-4044
Fax
(713) 588-1850
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X L7349 TX Primary

Addresses

Primary practice location

5373 W Alabama Street
Ste 204
Houston, TX 77056

Mailing address

PO Box 2868
Bellaire, TX 77402-2868
Phone (713) 714-4040

Other identifiers 1

IdentifierTypeStateIssuer
165376801MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, VI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040102000516 TX Practitioner - Thoracic SurgeryPractitioner - Vascular Surgery 3779482377 Reassigns benefits to 5 organizations
I20240221003460 VI Practitioner - Cardiovascular Disease (Cardiology) 3779482377 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
A & V Doctors PLLC CurrentSince Sep 29, 2017 Accepting new patients
Comprehensive Orthopedics LLC CurrentSince Jan 18, 2024 Accepting new patients
Vpa of Texas PLLC CurrentSince Apr 1, 2024 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Apr 1, 2024 Accepting new patients
Vpa of Texas PLLC Current Accepting new patients
Dynamic Anesthesia Providers PLLC Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Jan 1, 2021 Accepting new patients
Vpa of Texas PLLC CurrentSince Apr 1, 2024 Accepting new patients
Emergency Hospital Systems LLC CurrentSince May 13, 2023 Accepting new patients
Wellspring Cardiovascular & Thoracic Surgery, PA Thoracic Surgery (Cardiothoracic Vascular Surgery) PastSince Jun 16, 2003 Accepting new patients
Cardiovascular Care Providers, Inc. Past Accepting new patients
Liberty Medical Development, LLC PastSince Jan 18, 2024 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

7500 N Mesa St
Ste 210
El Paso, TX 79912
Phone (915) 307-2631

4615 Southwest Fwy
Ste 850
Houston, TX 77027
Phone (281) 475-4428

8901 FM 1960 Bypass Rd W
Ste 105
Humble, TX 77338
Phone (281) 592-5400

4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511

26710 Interstate 45
Ste B
Spring, TX 77386
Phone (281) 419-1117

4006 Estate Diamond
Ste 201
St Croix, VI 00820
Phone (340) 718-2665

9151 Estate Thomas
Ste 206
St Thomas, VI 00802

Organizations & group practices 11

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1528037975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2868",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774022868",
            "telephone_number": "713-714-4040",
            "fax_number": "713-588-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5373 W ALABAMA STREET",
            "address_2": "STE 204",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77056",
            "telephone_number": "713-714-4044",
            "fax_number": "713-588-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CORNELIUS",
        "middle_name": "ALEXANDER",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2021-08-12",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TX",
            "license": "L7349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165376801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.