John D Davidhizar Jr., MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

P8769 Issued in TX

Practice address

3201 University Dr E Ste 135
Bryan, TX 77802-3481

Phone

(979) 209-0458

Fax

(979) 213-5682

NPI assigned

Jun 1, 2011

Last updated

Aug 22, 2023By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Aug 22, 2023 through Aug 22, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Davidhizar Medical, PLLC

  dba MyMDbcs

  • Primary Care Clinic/Center
  • College Station, TX
  • NPI 1558761304
  NPD (past) Authorized official
• Jhancock Medical LLC

  dba Good Life Family Medicine

  • Family Medicine Physician
  • College Station, TX
  • NPI 1538879739
  NPD (past) Authorized official

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

{
    "created_epoch": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1922392430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 UNIVERSITY DR E STE 135",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023481",
            "telephone_number": "979-209-0458",
            "fax_number": "979-213-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 UNIVERSITY DR E STE 135",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023481",
            "telephone_number": "979-209-0458",
            "fax_number": "979-213-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDHIZAR",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-01",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP10041303",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P8769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather R Darcey, DDS
• Piyush Pravinkumar Darji, APRN
• Mahesh R Dave, M.D.
• Nalini M Dave, M.D.
• Katie Marie Davenport, PT, DPT
• Rhonda Rochell Davies, LCSW
• Chanseya A Davis, MD
• Cynthia Gregory Davis
• Lashonda Davis
• Rachel Davis

• Family Medicine Physician in Bryan, TX
• Providers in Bryan, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.