Provider Demographics
NPI:1013485770
Name:DAVIS HEALTH VENTURES LLC
Entity Type:Organization
Organization Name:DAVIS HEALTH VENTURES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NOAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SEITEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-823-9669
Mailing Address - Street 1:8528 DAVIS BLVD # 134-301
Mailing Address - Street 2:
Mailing Address - City:N RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-8367
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:380 E NORTHWEST HWY STE 202
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-2274
Practice Address - Country:US
Practice Address - Phone:817-503-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DAVIS HEALTH VENTURES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-10
Last Update Date:2018-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty