| Lisa A. Davis, M.d., P.a. | |
|
414 Navarro St Suite 1023 San Antonio TX 78205-2516 | |
| (210) 223-3246 | |
| (210) 223-1816 |
| Full Name | Lisa A. Davis, M.d., P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 414 Navarro St, San Antonio, Texas |
| Authorized Official Name and Position | Lisa A Davis (OWNER) |
| Authorized Official Contact | 2102233246 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa A. Davis, M.d., P.a. 414 Navarro St Suite 1023 San Antonio TX 78205-2516 Ph: (210) 223-3246 | Lisa A. Davis, M.d., P.a. 414 Navarro St Suite 1023 San Antonio TX 78205-2516 Ph: (210) 223-3246 |
| NPI Number | 1053505875 |
|---|---|
| Provider Enumeration Date | 09/05/2007 |
| Last Update Date | 02/27/2008 |
| Medicare PECOS PAC ID | 0749224715 |
|---|---|
| Medicare Enrollment ID | O20050610000856 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053505875 | NPI | - | NPPES |
| 0096GW | Other | TX | BCBS |
| CJ5947 | Other | TX | RAILROAD MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | H1945 (Texas) | Primary |
| Provider Name | Lisa A Davis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285648808 PECOS PAC ID: 9436291614 Enrollment ID: I20100928000097 |
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