Provider Demographics
NPI:1154480382
Name:DAVIS, GARVIN H (MD)
Entity Type:Individual
Prefix:
First Name:GARVIN
Middle Name:H
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4055 UNDERWOOD ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-1717
Mailing Address - Country:US
Mailing Address - Phone:832-647-1837
Mailing Address - Fax:
Practice Address - Street 1:6400 FANNIN ST
Practice Address - Street 2:SUITE 1800
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1521
Practice Address - Country:US
Practice Address - Phone:713-559-5200
Practice Address - Fax:713-795-0709
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6855207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170119503Medicaid
TX170119508Medicaid
TX1701195-05Medicaid
TX170119507OtherCSHCN
TX8D0872Medicare PIN
TX8L12697Medicare PIN
TXI23624Medicare UPIN
TX1701195-05Medicaid
TXP00231350Medicare PIN
TX8G2017Medicare ID - Type Unspecified