Provider Demographics
NPI:1831259399
Name:HOOD, DAVELYN EAVES (MD)
Entity type:Individual
Prefix:DR
First Name:DAVELYN
Middle Name:EAVES
Last Name:HOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2407 NORHAM DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-4884
Mailing Address - Country:US
Mailing Address - Phone:979-251-1468
Mailing Address - Fax:
Practice Address - Street 1:3370 SOUTH TEXAS AVENUE
Practice Address - Street 2:SUITE B
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802
Practice Address - Country:US
Practice Address - Phone:979-595-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6965207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1275620551OtherROBERTSON CHC NPI
TX154467801Medicaid
TX154467803Medicaid
1750470084OtherMADISON CHC NPI
TX185649401Medicaid
TX000951608Medicaid
TX1821185299OtherBVCAA, INC. AGENCY NPI
TX187842301Medicaid
1275726853OtherCOLLEGE STATION CHC NPI
1568519122OtherLEON CHC NPI
1649265646OtherBRYAN-COLLEGE STATION CHC NPI
1700973187OtherGRIMES CHC NPI
TX000951607Medicaid
1649265646OtherBRYAN-COLLEGE STATION CHC NPI
TX000951608Medicaid
1275726853OtherCOLLEGE STATION CHC NPI
21586Medicare UPIN
TX154467803Medicaid
TX451981Medicare Oscar/Certification
TX451942Medicare Oscar/Certification