Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | Q0239 | TX |
N | 2080N0001X | Neonatal-Perinatal Doctor | Q0239 | TX |
NPI | 1063679850 |
---|---|
Provider Name | Dr. Jonathan Davies |
First Address | Houston, TX 77030-2303 |
Second Address | Houston, TX 77030-2303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2008 |
Last Update Date | 17/06/2014 |