Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | E3889 | TX |
NPI | 1053345447 |
---|---|
Provider Name | Dr. Jaime Abraham Davidson |
First Address | Dallas, TX 75230-2505 |
Second Address | Dallas, TX 75230-2505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 24/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G14158 | (02) | TX |