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Deactivated NPI 1699760603 Deactivated / Inactive NPI Male Practitioner

Dr. Mark Keith Davis , OD

Optometrist • San Antonio, TX

✓ Accepts Medicare Assignment
⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Mark Davis has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 15, 2005
NPI Deactivation Date March 23, 2006
Total Practice Duration ~20 Years of Practice (1986 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Mark Davis, OD was a registered Optometrist in San Antonio, TX. Prior to record deactivation on 2006-03-23, Dr. Davis completed approximately 20 years of clinical practice following graduation from University Of Houston - College Of Optometry in 1986.

Dr. Davis was affiliated with Central Texas Healthcare Services and accepted Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

1742 N Loop 1604 E
Suite 118

San Antonio, TX 782321593

Telephone 2104039050
Fax 2104039939
Associated Practice Facility / Clinic
🏢 Androzo Enterprises, Pllc Facility NPI 1275958712

Medicare Profile & Education

Medical School

University Of Houston - College Of Optometry

Graduation Year

1986

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in San Antonio, TX

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
40 Yrs +23.1 yrs vs City Avg
City Avg: 16.9 Yrs
State Avg: 19.5 Yrs
Regional Practice Density
390 Specialists

Practicing in San Antonio, TX (5156 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Davis (40 Years) 40 Yrs
San Antonio Specialty Average (16.9 Years) 16.9 Yrs

Medical Specialties & State Licenses

CMS Verified: 2026-03-24
Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License TX 3460

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
161053701 (TX)
Medicaid State Provider ID
100404603 (TX)
Commercial Insurance / Payer ID Bcbs
00000072FC (TX)
Commercial Insurance / Payer ID Humana
136734195824 (TX)
Commercial Insurance / Payer ID United Health Care
200122447 (TX)
Commercial Insurance / Payer ID Aetna
200122447 (TX)
Commercial Insurance / Payer ID Bcbs
80575Q (TX)

Hospital & Practice Group Affiliations

Central Texas Healthcare Services

150 River N Blvd, Stephenville, TX 764011860

Phone: 2543861600

Secondary Practice Locations

6328 Telephone Rd

Houston, TX 770875410

Phone: 7136442375

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1639912892

Doctor of Optometry

NPI 1992961874

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Business Mailing Address March 24, 2026

Registered at 1742 N LOOP 1604 E STE 118, SAN ANTONIO, TX 782321594

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 24, 2026

Optometrist (License #3460 in TX)

📍
Updated Practice Location November 06, 2015

Registered at 1742 N LOOP 1604 E, SUITE 118, SAN ANTONIO, TX 782321593 (Tel: 2104039050)

📍
Updated Business Mailing Address November 06, 2015

Registered at 6603 FM 2920 RD, SPRING KLEIN VISION CENTER, SPRING, TX 773792636 (Tel: 2813704444)

👤
Provider Name / Credentials Updated November 06, 2015

Recorded as MARK DAVIS, O.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 06, 2015

Optometrist (License #3460TG in TX)

🔄
NPI Profile Reactivated March 28, 2006

Record officially reactivated for active practice on March 28, 2006

⚠️
NPI Profile Deactivated March 23, 2006

Record deactivated on March 23, 2006

🟢
Initial NPI Registration & Enumeration September 15, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1699760603
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 15, 2005
Last Update: March 24, 2026
Deactivation Date: March 23, 2006
Sole Proprietor: No

Mailing Address

1742 N Loop 1604 E Ste 118

San Antonio, TX 782321594

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.