Provider Demographics
NPI:1619282670
Name:DAVES, ROY MILLER
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:MILLER
Last Name:DAVES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1138 INDIAN RDG
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-3542
Mailing Address - Country:US
Mailing Address - Phone:830-226-5446
Mailing Address - Fax:
Practice Address - Street 1:1368 E COURT ST
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-5131
Practice Address - Country:US
Practice Address - Phone:830-379-0160
Practice Address - Fax:830-401-0972
Is Sole Proprietor?:No
Enumeration Date:2010-08-15
Last Update Date:2010-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19224183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist