Davis, Anthony Dewayne

Davis, Anthony Dewayne is an individual health care provider with primary practice located at 1379 Brad Circle Ste A , Lindale TX 75771. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Davis, Anthony Dewayne can be contacted via phone (903) 881-5165.

Contact Information

Primary practice address
1379 Brad Circle Ste A Lindale TX 75771
Phone: (903) 881-5165
Fax: (903) 881-5175
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X K7710 Texas

Profile Details

NPI number 1962446898
LBN Legal business name Davis, Anthony Dewayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Mar 11th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962446898 NPPES
Texas MEDICAID 116319807
Texas Other P00017436

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