MARK OWEN DAVIS (NPI# 1831129097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831129097 |
| Entity Type | Individual |
| Full Name | MARK OWEN DAVIS |
| Credential | MD |
| Practice Address |
3501 Knickerbocker Rd San Angelo TX 76904-7610 |
| Mailing Address |
2502 Nasworthy Dr San Angelo TX 76904-5423 |
| Practice Telephone | 8008939698 |
| Mailing Telephone | 3259490413 |
| Mailing Fax Number | 8662041259 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2017-12-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | F9353 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE SHIELD | DA8V0608 | 01 |
| TX | 139438919 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780225250 | Mark N Davis | Psychologist | 1479 Oak Ridge Dr, Chico, CA 95928-8856 | 2019-10-04 |
| 1841731924 | Mark Davis | Anesthesiology | 8237 Blackburn Ave Apt 103, Los Angeles, CA 90048-4277 | 2017-03-09 |
| 1336599588 | Mark Randall Davis | Specialist/Technologist | 1437 6th Street Cir Nw, Hickory, NC 28601-5255 | 2016-06-20 |
| 1891104865 | Mark Davis | Home Health Aide | 1916 Millgate Rd, Anderson, SC 29621-2936 | 2014-08-04 |
| 1457786998 | Mark Henderson Davis | Social Worker | 5384 Street Ne, Community Options Fridley, Fridley, MN 55421 | 2013-09-03 |
| 1699114082 | Mark David Davis | Behavioral Analyst | 12420 S Ridgeland Ave, Palos Heights, IL 60463-1858 | 2013-06-18 |
| 1376813808 | Mark Stephen Davis | Specialist | 4453 Mount Paran Pkwy Nw, Atlanta, GA 30327-3721 | 2011-12-30 |
| 1295053254 | Mark Davis | Pharmacist | 4185 Washington Rd, Mc Murray, PA 15317-2522 | 2010-05-13 |
| 1194968826 | Mark Anthony Davis | Driver | 448 E 272nd St, Euclid, OH 44132-1730 | 2009-04-10 |
| 1750542460 | Mark Alan Davis Sr. | Counselor | 147 Bryn Mawr Ave, Lansdowne, PA 19050-1806 | 2008-06-24 |
| Street Address |
3501 KNICKERBOCKER RD |
| City | SAN ANGELO |
| State | TX |
| Zip Code | 76904-7610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487622403 | Randell Gene Matthews | Specialist/Technologist | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2006-03-08 |
| 1700231248 | Kyle Mills | Internal Medicine | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2016-05-03 |
| 1710341508 | Anthony Mcdonald | Internal Medicine | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2016-04-08 |
| 1972966000 | Yotham Fraenkel | Internal Medicine | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2016-04-05 |
| 1386012037 | Crystal Sustaita | Nurse Anesthetist, Certified Registered | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2015-09-11 |
| 1659769198 | Joe Riley Mcfarland | Nurse Anesthetist, Certified Registered | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2015-01-07 |
| 1154748671 | Caesasonia Pascual Agatep | Nurse Practitioner | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2014-03-21 |
| 1588009807 | San Angelo Emergency Medicine Associates Pa | Physician Assistant | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2013-04-30 |
| 1982048682 | Crystal Collin Kirkland | Internal Medicine | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2013-04-24 |
| 1457606154 | Oasis of West Tx Emergency | Physician Assistant | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2012-07-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407342702 | Mark Wandal Duncan | Specialist/Technologist | 2237 South Jackson, San Angelo, TX 76904 | 2018-07-10 |
| 1700267259 | Sheila Patterson | Nurse Practitioner | 4251 Sunset Drive, San Angelo, TX 76904 | 2015-06-10 |
| 1346649316 | Mason William Mcclintock | Dentist | 2402 College Hills Blvd. Building 1, Building 1, San Angelo, TX 76904 | 2014-08-15 |
| 1265855712 | Lynn M. Thebo, Lcsw, Pllc | Social Worker | 3109 Southwest Blvd. Ste. B, San Angelo, TX 76904 | 2014-02-03 |
| 1487077459 | Lynn Marie Thebo | Social Worker | 3109 Southwest Blvd., Ste. B, San Angelo, TX 76904 | 2014-01-28 |
| 1558646521 | John Porter Parker Jr. | Pharmacist | 3705 Threewn Trail, San Angelo, TX 76904 | 2011-10-20 |
| 1568772036 | Medical Alliance Group of Texas, LLC | Durable Medical Equipment & Medical Supplies | 2525 S Johnson Ste A, San Angelo, TX 76904 | 2010-10-18 |
| 1578796710 | Jennifer L White | Physical Therapist | 2237 S. Jackson, San Angelo, TX 76904 | 2009-09-03 |
| 1548443203 | Kelly K. Sawyer, D.d.s., P.a. | Dentist | 3013 W. Loop 306, San Angelo, TX 76904 | 2007-12-17 |
| 1023224789 | D&s Residential Services | Intermediate Care Facility, Mentally Retarded | 1706 Idaho Avenue, San Angelo, TX 76904 | 2007-05-16 |
| Find all providers in zip 76904 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891921409 | John George Speck | Emergency Medicine | 5709 Sherwood Way, San Angelo, TX 76901-5643 | 2009-06-09 |
| 1043424021 | Michael Patrick Strayer | Emergency Medicine | 3501 Kinickerbocker Rd, San Angelo, TX 76904-0000 | 2007-05-09 |
| 1952458986 | Brian David Rappe | Emergency Medicine | 2613 Southland Blvd, #10, San Angelo, TX 76904-7551 | 2007-01-04 |
| 1215957873 | David Charles Herbert | Emergency Medicine | 1842 South Concho Dr, San Angelo, TX 76904-7970 | 2006-07-19 |
| 1538101571 | Michael Ray Hambrick | Emergency Medicine | 2142 Sunset Drive, San Angelo, TX 76904 | 2006-06-12 |
| 1154322014 | Brett Jason Nile | Emergency Medicine | 3101 Rigdecrest Lane, San Angelo, TX 76904 | 2005-08-02 |
| 1972062545 | Concho Valley Emergency Physicians Pllc | Emergency Medicine | 5709 Sherwood Way, San Angelo, TX 76901-5643 | 2019-03-13 |
| 1679912083 | Chali Mulenga | Emergency Medicine | 120 E Harris Ave, San Angelo, TX 76903-5904 | 2013-06-19 |
| 1861710576 | Kelly Lee Koenig | Emergency Medicine | 120 E Harris Ave, San Angelo, TX 76903-5904 | 2010-05-06 |
| 1922245067 | Del Mar Emergency Physicians, LLP | Emergency Medicine | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2009-01-12 |
| Find all providers in SAN ANGELO | ||||
| City | SAN ANGELO |
| Zip Code | 76904 |
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| 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.