Provider Demographics
NPI:1649275371
Name:DAVIDSON-COX, KARLA K (MD)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:K
Last Name:DAVIDSON-COX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 NW JOHN JONES DR
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-8040
Mailing Address - Country:US
Mailing Address - Phone:817-945-3163
Mailing Address - Fax:817-717-5186
Practice Address - Street 1:1308 NW JOHN JONES DR
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028
Practice Address - Country:US
Practice Address - Phone:817-945-3163
Practice Address - Fax:817-717-5186
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2019-03-06
Deactivation Date:2006-03-30
Deactivation Code:
Reactivation Date:2006-04-18
Provider Licenses
StateLicense IDTaxonomies
TXL6025207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159267701Medicaid
TXH84403Medicare UPIN