Provider Demographics
NPI:1447293915
Name:DAVIDSON, JAMES A (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:DAVIDSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8210 WALNUT HILL LN
Mailing Address - Street 2:SUITE 513 LB43
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4405
Mailing Address - Country:US
Mailing Address - Phone:214-696-2890
Mailing Address - Fax:214-373-6735
Practice Address - Street 1:8210 WALNUT HILL LN
Practice Address - Street 2:SUITE 513 LB43
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4405
Practice Address - Country:US
Practice Address - Phone:214-696-2890
Practice Address - Fax:214-373-6735
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG0987208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX123433802Medicaid
TX123433802Medicaid
TXD48185Medicare UPIN