NPIMap

Individual provider Active NPI

William Grant Davis, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Tyler, TX
National Provider Identifier
1578504007
Registry record updated Oct 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
N8181 Issued in TX
Practice address
800 E. Dawson
Trinity Mother Frances Hospital
Tyler, TX 75701
Phone
(512) 814-0298
Fax
(512) 597-2713
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X N8181 TX Primary

Addresses

Primary practice location

800 E. Dawson
Trinity Mother Frances Hospital
Tyler, TX 75701

Mailing address

PO Box 2386
Brazos Valley Pathology
Round Rock, TX 78664
Phone (903) 944-8991

Other identifiers 2

IdentifierTypeStateIssuer
TXB134816OtherTXMEDICARE
0808107MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250414001917 OK Practitioner - Pathology 9032143557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Oklahoma State University College of Osteopathic Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology Group PCGroup PAC ID 6103993167, 9 clinicians

Practice addresses (Care Compare)

1000 N Lee Ave
Oklahoma City, OK 73102-1036
Phone (405) 272-7065

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
N8181TXMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Group PC Anatomic Pathology & Clinical Pathology CurrentSince Apr 1, 2025 Accepting new patients
Austin Pathology Associates Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

5700 Southwyck Blvd
Toledo, OH 43614

1000 N Lee Ave
Oklahoma City, OK 73102
Phone (405) 272-6152

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

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 and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414713600000",
    "number": "1578504007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2386",
            "address_2": "BRAZOS VALLEY PATHOLOGY",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "78664",
            "telephone_number": "903-944-8991",
            "fax_number": "512-597-2713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E. DAWSON",
            "address_2": "TRINITY MOTHER FRANCES HOSPITAL",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "512-814-0298",
            "fax_number": "512-597-2713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "WILLIAM",
        "middle_name": "GRANT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2014-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "N8181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "TXB134816",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0808107",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.