DR. JERRY THOMAS DAVIS (NPI# 1821179003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821179003 |
| Entity Type | Individual |
| Full Name | DR. JERRY THOMAS DAVIS |
| Credential | DO |
| Practice Address |
6302 A Jacksboro Hwy Fort Worth TX 76135-3602 |
| Mailing Address |
3963 Boat Club Rd Ft Worth TX 76135-3202 |
| Practice Telephone | 8172378273 |
| Practice Fax Number | 8172370374 |
| Mailing Telephone | 8172378273 |
| Mailing Fax Number | 8172370374 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2016-08-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | F9351 | TX | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356357495 | Jerry Wayne Davis | General Acute Care Hospital | 2715 Avenue N, Nederland, TX 77627-7814 | 2006-07-31 |
| 1457323560 | Jerry Davis | Counselor | 1530 Commerce Park West Drive, Greensburg, IN 47240 | 2006-02-02 |
| 1578046538 | Jerry L Davis Jr. | Behavior Technician | 4778 Overton Rd, Birmingham, AL 35210-3803 | 2018-09-14 |
| 1306298591 | Jerry Davis | Counselor | 3401 Eudora St, Denver, CO 80207-2500 | 2016-07-12 |
| 1699083436 | Jerry Heath Davis | Pharmacist | 120 Carbon City Rd, Morganton, NC 28655-4226 | 2010-09-15 |
| 1225365265 | Jerry Bernard Davis | Pharmacist | 6551 Forest Hill Dr, Forest Hill, TX 76140-1205 | 2009-11-12 |
| 1932300563 | Jerry Davis | Counselor | 348 13th St, Brooklyn, NY 11215-5004 | 2007-05-30 |
| 1912045683 | Jerry Davis | Pharmacist | 310 15th Ave E, Seattle, WA 98112-5103 | 2007-02-02 |
| 1639220684 | Jerry Carl Davis | Pharmacist | 110 W 2nd St, Kenly, NC 27542 | 2007-01-16 |
| 1114003597 | Jerry Robert Davis | Dentist | 494 S Emerson Ave, Suite K, Greenwood, IN 46143-1912 | 2006-10-28 |
| Street Address |
6302 A JACKSBORO HWY |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76135-3602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639237258 | Max S Hughes | Family Medicine | 6302 A Jacksboro Hwy, Fort Worth, TX 76135 | 2006-12-05 |
| 1811055403 | Tamara K Hanby | Family Medicine | 6302 A Jacksboro Hwy, Fort Worth, TX 76135-3602 | 2006-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992283501 | Sung Ryel Choi | Dentist | 6014 Azle Ave # 100, Lake Worth, TX 76135 | 2018-08-06 |
| 1750882056 | Kandess Klein | Licensed Vocational Nurse | 8825 Claiborn St, Lakeside, TX 76135 | 2018-02-22 |
| 1841791258 | Robyn Rich | Technician | 5104 Prestwick Drive, Fort Worth, TX 76135 | 2018-02-22 |
| 1598207821 | Young Men's Christian Association of Metropolitan Fort Worth | Health Educator | 5315 Boat Club Rd, Fort Worth, TX 76135 | 2016-11-17 |
| 1558818534 | Clearfork Academy Lp | Substance Abuse Rehabilitation Facility | 7820 Hanger Cut Off, Fort Worth, TX 76135 | 2016-09-07 |
| 1316300999 | National Vision, Inc. | Technician/Technologist | 6014 Azle Ave, Ste 200, Lake Worth, TX 76135 | 2016-04-01 |
| 1457647570 | Cynthia Rosaline Witt | Optometrist | 6014 Azle Avenue, Suite 300, Lake Worth, TX 76135 | 2011-06-27 |
| 1316134125 | Home Town Dental,pa | Dentist | 6332 Lake Worth, Lake Worth, TN 76135 | 2007-09-26 |
| 1790984789 | Jonathan Nicholas Valamides | Optometrist | 6060 Azle Ave. Suite 500, Lake Worth, TX 76135 | 2007-07-11 |
| 1457570053 | Dawn Denise Ezelle | Occupational Therapy Assistant | 3400 Marine Drive, Fort Worth, TX 76135 | 2007-04-24 |
| Find all providers in zip 76135 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770184020 | Kara Fenceroy | Family Medicine | 5425 Rolling Meadows Dr, Fort Worth, TX 76123-2836 | 2020-11-03 |
| 1003416207 | Adeline Galvez | Family Medicine | 1300 W Terrell Ave Ste 270, Fort Worth, TX 76104-2820 | 2020-10-27 |
| 1952870354 | Nancy Carolina Nicoloso | Family Medicine | 6302 Lake Worth Blvd Ste A3963, Fort Worth, TX 76135-3607 | 2018-11-15 |
| 1245717586 | Julia Dubose | Family Medicine | 4100 Heritage Trace Pkwy Ste 116, Fort Worth, TX 76244 | 2018-07-19 |
| 1609307115 | Yara Hamade Gonzales | Family Medicine | 4701 Bryant Irvin Rd, Fort Worth, TX 76132-3603 | 2017-03-26 |
| 1558732321 | Andres Morgado Perez | Family Medicine | 1325 Pennsylvania Ave Ste 750, Fort Worth, TX 76104-2168 | 2015-10-19 |
| 1114304805 | Davis Wellness Ltd LLP | Family Medicine | 3750 S. University Dr., Suite 201, Fort Worth, TX 76109-3701 | 2015-05-01 |
| 1902298417 | Jack Lynwood Judson, Md | Family Medicine | 1800 Malibar Rd, Fort Worth, TX 76116-1834 | 2015-02-21 |
| 1104243468 | Henry Dollahite | Family Medicine | 6205 Locke Ave, Fort Worth, TX 76116-4636 | 2014-03-25 |
| 1447676689 | Janet Shackelford | Family Medicine | 5001 Golden Triangle Blvd, # 1024, Fort Worth, TX 76244 | 2014-03-12 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76135 |
Please comment or provide details below to improve the information on DR. JERRY THOMAS DAVIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.