Provider Demographics
NPI:1750668596
Name:DAVIS, WILLIAM BRYANT (R EP T, CNIM)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:BRYANT
Last Name:DAVIS
Suffix:
Gender:M
Credentials:R EP T, CNIM
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:233 EDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:TX
Mailing Address - Zip Code:77486-8600
Mailing Address - Country:US
Mailing Address - Phone:832-533-6854
Mailing Address - Fax:713-510-1995
Practice Address - Street 1:233 EDGEWATER DR
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:TX
Practice Address - Zip Code:77486-8600
Practice Address - Country:US
Practice Address - Phone:832-533-6854
Practice Address - Fax:713-510-1995
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXABRET 1484246ZE0600X
TXABRET 953246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic