Provider Demographics
NPI:1043885841
Name:DAVIS, JOE RICHARD (RPH)
Entity type:Individual
Prefix:
First Name:JOE
Middle Name:RICHARD
Last Name:DAVIS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10650 W AIRPORT BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-3066
Mailing Address - Country:US
Mailing Address - Phone:281-776-8860
Mailing Address - Fax:800-973-3455
Practice Address - Street 1:10650 W AIRPORT BLVD STE 150
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3066
Practice Address - Country:US
Practice Address - Phone:281-776-8860
Practice Address - Fax:800-973-3455
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX228291835P1200X, 1835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy