Provider Demographics
NPI:1982613378
Name:DAVIS, ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929-B GESSNER
Mailing Address - Street 2:SUITE 106
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2527
Mailing Address - Country:US
Mailing Address - Phone:713-464-6000
Mailing Address - Fax:713-464-6002
Practice Address - Street 1:929-B GESSNER
Practice Address - Street 2:SUITE 106
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2527
Practice Address - Country:US
Practice Address - Phone:713-464-6000
Practice Address - Fax:713-464-6002
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE3676208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1700040OtherUNITEDHEALTHCARE
TX0813526002OtherCIGNA
TX826023392OtherRAILROAD MEDICARE
TX87Y070OtherBUE CROSS
TX097368702Medicaid
TX4126009OtherAETNA
TX097368702Medicaid
TX87Y070OtherBUE CROSS