Mark Keith Davis, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3460 Issued in TX

Practice address

1742 N Loop 1604 E
Suite 118
San Antonio, TX 78232-1593

Phone

(210) 403-9050

Fax

(210) 403-9939

NPI assigned

Sep 15, 2005

Reactivated

Mar 28, 2006

Last updated

Mar 24, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Central Texas Healthcare Services

  dba Central Texas Surgical Services

  • Surgery Physician
  • Stephenville, TX
  • NPI 1609400209
  Medicare reassignment NPD
• Med Southwest, PLLC

  dba MyEyeDr.

  • Optometrist
  • Houston, TX
  • NPI 1609348739
  Medicare reassignment NPD
• Premise Health of Texas Medical PA

  dba Westlake Health and Wellness Center

  • Multi-Specialty Clinic/Center
  • Houston, TX
  • NPI 1558640854
  Medicare reassignment NPD
• University of Houston System

  dba University Eye Institute

  • Optometrist
  • Houston, TX
  • NPI 1861493140
  Medicare reassignment NPD
• Central Texas Healthcare Services

  dba Hico Physical Therapy Clinic

  • Physical Therapy Clinic/Center
  • Hico, TX
  • NPI 1316625551
  NPD
• Med Southwest, PLLC

  dba MyEyeDr.

  • Optometrist
  • Corsicana, TX
  • NPI 1043855174
  NPD
• Premise Health of Texas Medical PA

  dba Premise Health Wellness Center - Plano Nearsite

  • Multi-Specialty Clinic/Center
  • Plano, TX
  • NPI 1881252450
  NPD
• University of Houston

  • Community Health Worker
  • Houston, TX
  • NPI 1366081622
  NPD
• Med Southwest, PLLC

  • Optometrist
  • Oklahoma City, OK
  • NPI 1679440762
  NPD
• Abdep LP

  dba Eye Tx Vision Centers

  • Optometrist
  • San Antonio, TX
  • NPI 1760404388
  NPD (past)
• Androzo Enterprises, PLLC

  • Corneal and Contact Management Optometrist
  • San Antonio, TX
  • NPI 1275958712
  NPD (past)
• Dr Rosa C Suarez-Reyna and Associates

  dba Northwest Family Eye Care

  • Optometrist
  • San Antonio, TX
  • NPI 1932452968
  NPD (past)

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1699760603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1742 N LOOP 1604 E STE 118",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1742 N LOOP 1604 E",
            "address_2": "SUITE 118",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321593",
            "telephone_number": "210-403-9050",
            "fax_number": "210-403-9939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6328 Telephone Rd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770875410",
            "country_code": "US",
            "telephone_number": "713-644-2375",
            "fax_number": "713-644-0486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MARK",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "deactivation_date": "2006-03-23",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "136734195824",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "200122447",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "80575Q",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "200122447",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00000072FC",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100404603",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161053701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Larry R. Davis, M.D.
• Laurie Michelle Davis, MD
• Lindsay Nicole Davis
• Lisa Anne Davis, M.D.
• Mark Adrian Davis, PTA
• Marlene Rose Davis, RD/LD
• Mary Angeline Marquez Davis, RN
• Mary Ann Davis
• Michael Davis, LVN
• Michael Scot Davis, D.D.S.

• Optometrist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.