Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | F4083 | TX |
NPI | 1023012556 |
---|---|
Provider Name | Patricia Marie Davis |
First Address | El Paso, TX 79938-2639 |
Second Address | El Paso, TX 79938-2639 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2005 |
Last Update Date | 25/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0974578-02 | (05) | TX |
E02186 | (02) | TX |