Provider Demographics
NPI:1013190537
Name:HONG DAVIS, MD, PA
Entity Type:Organization
Organization Name:HONG DAVIS, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HONG
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-867-5888
Mailing Address - Street 1:6300 STONEWOOD DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-5280
Mailing Address - Country:US
Mailing Address - Phone:972-867-5888
Mailing Address - Fax:972-867-4888
Practice Address - Street 1:6300 STONEWOOD DR
Practice Address - Street 2:SUITE 202
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-5280
Practice Address - Country:US
Practice Address - Phone:972-867-5888
Practice Address - Fax:972-867-4888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX509812363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173715701Medicaid
TX00487WMedicare PIN
TX173715701Medicaid