Provider Demographics
NPI:1831312099
Name:DAVIS, ERIC (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:DAVIS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 PRESTON PARK BLVD
Mailing Address - Street 2:STE 2400
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3716
Mailing Address - Country:US
Mailing Address - Phone:972-867-7862
Mailing Address - Fax:972-612-1623
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-5302
Practice Address - Country:US
Practice Address - Phone:409-772-1011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY241409-12085N0700X
TXM79342085R0202X, 2085N0700X
AK2316032085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology