Provider Demographics
NPI:1326045782
Name:DAVIS, WILLIAM C (CHIROPRACTOR)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:C
Last Name:DAVIS
Suffix:
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 NW MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ENNIS
Mailing Address - State:TX
Mailing Address - Zip Code:75119-4053
Mailing Address - Country:US
Mailing Address - Phone:972-875-9377
Mailing Address - Fax:
Practice Address - Street 1:109 NW MAIN ST
Practice Address - Street 2:
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-4053
Practice Address - Country:US
Practice Address - Phone:972-875-9377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2021-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8285111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU77542Medicare UPIN
TX609305Medicare PIN