Provider Demographics
NPI:1962847376
Name:DAVIS, JACOB TRAVIS (MD)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:TRAVIS
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 848491
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-8491
Mailing Address - Country:US
Mailing Address - Phone:800-994-0371
Mailing Address - Fax:254-215-9722
Practice Address - Street 1:2201 MACARTHUR DR STE 2205
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-3159
Practice Address - Country:US
Practice Address - Phone:254-202-8980
Practice Address - Fax:254-730-2692
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-30
Last Update Date:2021-01-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXQ9982207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma