Individual provider Active NPI

Daniel Garrett Davis

  • Student in an Organized Health Care Education/Training Program
  • Lubbock, TX
National Provider Identifier
1750955720
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3601 4TH St
Lubbock, TX 79430-0002
Phone
(806) 743-3150
NPI assigned
May 14, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

3601 4TH St
Lubbock, TX 79430-0002

Mailing address

223 Indiana Ave Apt 4207
Lubbock, TX 79415-5360
Phone (512) 653-9708

Other practice location 1

602 Indiana Ave
Lubbock, TX 79415-3364
Phone (806) 775-9700

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210701003850 TX Order and Referring Only - GastroenterologyPractitioner - GastroenterologyPractitioner - Internal Medicine 4284035890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1620950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1750955720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 INDIANA AVE APT 4207",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794155360",
            "telephone_number": "512-653-9708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 4TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794300002",
            "telephone_number": "806-743-3150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "602 Indiana Ave",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794153364",
            "country_code": "US",
            "telephone_number": "806-775-9700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DANIEL",
        "middle_name": "GARRETT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-14",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.