Provider Demographics
NPI:1083813430
Name:DAVENPORT, LOUIS ANDREW (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:ANDREW
Last Name:DAVENPORT
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4309 EMMA BROWNING AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78719-3327
Mailing Address - Country:US
Mailing Address - Phone:512-843-5559
Mailing Address - Fax:
Practice Address - Street 1:4309 EMMA BROWNING AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78719-3327
Practice Address - Country:US
Practice Address - Phone:512-843-5559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN07162083A0100X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine