Provider Demographics
NPI:1497895411
Name:DAVIS, PAUL ANTHONY (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ANTHONY
Last Name:DAVIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 CEDAR BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-0805
Mailing Address - Country:US
Mailing Address - Phone:281-332-6413
Mailing Address - Fax:
Practice Address - Street 1:3750 MEDICAL PARK DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539
Practice Address - Country:US
Practice Address - Phone:281-534-1133
Practice Address - Fax:281-534-2190
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8030111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation