Provider Demographics
NPI:1770768129
Name:ROYAL DAVY, LLC
Entity type:Organization
Organization Name:ROYAL DAVY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDULRAHMAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:AL-NAIMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:832-886-2758
Mailing Address - Street 1:54 SUGAR CREEK CENTER BLVD
Mailing Address - Street 2:300
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4064
Mailing Address - Country:US
Mailing Address - Phone:832-886-2758
Mailing Address - Fax:832-886-2858
Practice Address - Street 1:54 SUGAR CREEK CENTER BLVD
Practice Address - Street 2:300
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4064
Practice Address - Country:US
Practice Address - Phone:832-886-2758
Practice Address - Fax:832-886-2858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-04
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0594207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0038DHOtherBCBS
TX85450ZOtherBCBS
TX8F4130OtherBCBS
TX1777819OtherUNITED HEALTH CARE
TX142683501Medicaid
TX142683501Medicaid