Provider Demographics
NPI:1912698929
Name:DAVIS, ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:TTUHSC DEPARTMENT OF OPHTHALMOLOGY AND VISUAL SCIENCES
Mailing Address - Street 2:3601 4TH STREET - STOP MS 7217, ROOM 2A100
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430
Mailing Address - Country:US
Mailing Address - Phone:806-743-2020
Mailing Address - Fax:
Practice Address - Street 1:TTUHSC DEPARTMENT OF OPHTHALMOLOGY AND VISUAL SCIENCES
Practice Address - Street 2:3601 4TH STREET - STOP MS 7217, ROOM 2A100
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430
Practice Address - Country:US
Practice Address - Phone:806-743-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-19
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10083614390200000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program