Mdo2, PLLC

Primary specialty

Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X

Legal business name

MDO2, PLLC

Practice address

3716 Standridge Dr
The Colony, TX 75056-4566

Phone

(972) 816-5969

NPI assigned

Jun 16, 2020

Organization subpart

No

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

Authorized official

Name

Otis Robert Davis, MD

Title

Manager/ Owner

Phone

(972) 816-5969

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• O Robert Davis, MD

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1194753152
  NPD

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592265600000",
    "number": "1629693593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3217 HUNTER LN",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938826",
            "telephone_number": "972-816-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3716 STANDRIDGE DR",
            "city": "THE COLONY",
            "state": "TX",
            "postal_code": "750564566",
            "telephone_number": "972-816-5969"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3217 Hunter Ln",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750938826",
            "country_code": "US",
            "telephone_number": "972-816-5969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MDO2, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-16",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "OTIS",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "MANAGER/ OWNER",
        "authorized_official_telephone_number": "972-816-5969",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1194753152",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in The Colony, TX
• Providers in The Colony, TX by specialty
• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.