Provider Demographics
NPI:1437277381
Name:DAVIS, STEVEN QUINTON (MD MS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:QUINTON
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD MS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:200 W MAGNOLIA AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-7657
Mailing Address - Country:US
Mailing Address - Phone:817-702-1395
Mailing Address - Fax:817-702-3603
Practice Address - Street 1:1500 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4917
Practice Address - Country:US
Practice Address - Phone:817-702-1395
Practice Address - Fax:817-702-3603
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7935207R00000X, 207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX193812801Medicaid
TX8K7951Medicare PIN