Provider Demographics
NPI:1477085579
Name:DAVIES, MICHAEL (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:DAVIES
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BLDG. 3031
Mailing Address - Street 2:
Mailing Address - City:CAMP HUMPHREYS
Mailing Address - State:KOREA
Mailing Address - Zip Code:96271
Mailing Address - Country:KR
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1305 WONDER WORLD DR STE 209
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7541
Practice Address - Country:US
Practice Address - Phone:512-353-6400
Practice Address - Fax:512-396-1349
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU0101207V00000X
VA0102205454207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology