Provider Demographics
NPI:1699801720
Name:DAVIS, PATRICK EDWARD (MD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:EDWARD
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4803 OSBORN GLADE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-5843
Mailing Address - Country:US
Mailing Address - Phone:210-268-3721
Mailing Address - Fax:
Practice Address - Street 1:401 W POPLAR ST
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-2846
Practice Address - Country:US
Practice Address - Phone:509-897-5850
Practice Address - Fax:509-897-5887
Is Sole Proprietor?:No
Enumeration Date:2007-02-25
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE239622085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology