Provider Demographics
NPI:1720388069
Name:DAVIS, MICHAEL JUDD (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JUDD
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9450 SW GEMINI DR
Mailing Address - Street 2:PMB49084
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008
Mailing Address - Country:US
Mailing Address - Phone:713-461-2915
Mailing Address - Fax:713-461-5307
Practice Address - Street 1:600 N SHEPHERD DR STE 530
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-4634
Practice Address - Country:US
Practice Address - Phone:713-461-2915
Practice Address - Fax:713-461-5307
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2023-10-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXH3015207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXA48596Medicare UPIN