NPIMap

Individual provider Active NPI

Garry Todd Davis, D.O.

  • Family Medicine Physician
  • Comanche, TX
National Provider Identifier
1699748434
Registry record updated Jun 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L6344 Issued in TX
Practice address
10201 Highway 16
Comanche, TX 76442-4462
Phone
(254) 879-4910
Fax
(254) 879-4991
NPI assigned
Feb 10, 2006
Last updated
Jun 28, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L6344 TX Primary

Addresses

Primary practice location

10201 Highway 16
Comanche, TX 76442-4462

Mailing address

PO Box 128
Comanche, TX 76442-0128
Phone (254) 879-4910

Other identifiers 2

IdentifierTypeStateIssuer
P00364190OtherTXRR MEDICARE
160855603MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20031231000673 TX Practitioner - Family Practice 7315846011 Reassigns benefits to 1 organization
Practice locations: Comanche, TX

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas Tech University Health Science Center School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10201 Hwy 16
Comanche, TX 76442-4462
Phone (254) 879-4900

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Comanche County Consolidated Hospital District Past Accepting new patients
Comanche County Medical Center Company Past Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 9

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214611200000",
    "number": "1699748434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 128",
            "city": "COMANCHE",
            "state": "TX",
            "postal_code": "764420128",
            "telephone_number": "254-879-4910",
            "fax_number": "254-879-4991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 HIGHWAY 16",
            "city": "COMANCHE",
            "state": "TX",
            "postal_code": "764424462",
            "telephone_number": "254-879-4910",
            "fax_number": "254-879-4991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "GARRY",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2008-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L6344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00364190",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160855603",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Comanche, TX

Sources for this page

Verify at the official NPI Registry.