Provider Demographics
NPI:1114304805
Name:DAVIS WELLNESS LTD LLP
Entity Type:Organization
Organization Name:DAVIS WELLNESS LTD LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:MCCALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:682-312-7919
Mailing Address - Street 1:3750 S. UNIVERSITY DR.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-3701
Mailing Address - Country:US
Mailing Address - Phone:682-312-7919
Mailing Address - Fax:817-920-1855
Practice Address - Street 1:3750 S. UNIVERSITY DR.
Practice Address - Street 2:SUITE 201
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-3701
Practice Address - Country:US
Practice Address - Phone:682-312-7919
Practice Address - Fax:817-920-1855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-01
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty