Provider Demographics
NPI:1194753152
Name:DAVIS, O ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:O
Middle Name:ROBERT
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:17480 DALLAS PKWY
Mailing Address - Street 2:SUITE 125
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-7337
Mailing Address - Country:US
Mailing Address - Phone:972-488-8926
Mailing Address - Fax:972-881-4390
Practice Address - Street 1:6757 ARAPAHO RD
Practice Address - Street 2:STE 711 PMB 335
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-4005
Practice Address - Country:US
Practice Address - Phone:972-488-8926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ5299207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F74320Medicare UPIN
TX8A4480Medicare PIN
TX8A4479Medicare PIN