Provider Demographics
NPI:1407070477
Name:MICHAEL K DAVIDSON, M.D.
Entity Type:Organization
Organization Name:MICHAEL K DAVIDSON, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIDSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-655-0073
Mailing Address - Street 1:1315 ST JOSEPH PKWY STE 1503
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8237
Mailing Address - Country:US
Mailing Address - Phone:713-655-0073
Mailing Address - Fax:713-655-1332
Practice Address - Street 1:1315 ST JOSEPH PKWY STE 1503
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8237
Practice Address - Country:US
Practice Address - Phone:713-655-0073
Practice Address - Fax:713-655-1332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty