LAKE WORTH MINOR EMERGENCY
NPI 1215217229
Family Medicine in Fort Worth, TX

Q: What is Jerry T. Davis D.O.,p.A.'s NPI number?

The NPI number for Jerry T. Davis D.O.,p.A. is 1215217229. It was assigned to this organization in the NPPES registry on August 22, 2011. The provider is also known as Lake Worth Minor Emergency.

Q: What is Jerry T. Davis D.O.,p.A.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since August 22, 2011CLIA 45D2198382 · Waiver

6302 JACKSBORO HWY STE A, FORT WORTH, TX 76135(817) 237-8273(817) 237-0374 Get Directions Write a Review

NPPES record last updated: October 17, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Lake Worth Minor Emergency NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE WORTH MINOR EMERGENCY (NPI 1215217229) is a healthcare organization registered as a family medicine in Fort Worth, Texas and active in the NPI registry since August 2011. The organization holds a CLIA Waiver certificate valid through November 1, 2026 and lists Glenda Wright, Manager, as its authorized official.

NPPES Registry Identity

NPI1215217229

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameJERRY T. DAVIS D.O.,P.A.

Location Address6302 JACKSBORO HWY STE AFort Worth, TX 76135-3607

Mailing Address6302 Jacksboro Hwy Ste AFort Worth, TX 76135-3607 · (817) 237-8273 · Fax (817) 237-0374

Phone(817) 237-8273

Fax(817) 237-0374

Organization SubpartNo

Authorized OfficialGlenda WrightManager · (817) 237-8273

Enumeration DateAugust 22, 2011

Last NPPES UpdateOctober 17, 2011

✔ NPI 1215217229 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in TX · F9351

Definition

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.

6302 JACKSBORO HWY STE A, Fort Worth, TX 76135

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Other Names 1

Other NameLake Worth Minor Emergency

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2198382

Lake Worth Minor Emergency Clinic · Fort Worth, TX

Active · expires Nov 1, 2026

CLIA Number45D2198382

Laboratory TypePhysician Office

Certificate Effective DateNovember 2, 2024

Certificate Expiration DateNovember 1, 2026

Laboratory DirectorJerry Davis

Laboratory Phone(817) 237-8273

Laboratory LocationLake Worth Minor Emergency Clinic6302 A Jacksboro Hwy, Fort Worth, TX 76135

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jerry T. Davis D.O.,p.A.'s NPI number?

The NPI number for Jerry T. Davis D.O.,p.A. is 1215217229. It was assigned to this organization in the NPPES registry on August 22, 2011. The provider is also known as Lake Worth Minor Emergency.

Where is Jerry T. Davis D.O.,p.A. located?

Jerry T. Davis D.O.,p.A. is located at 6302 Jacksboro Hwy Ste A, Fort Worth, TX 76135. The listed phone number is (817) 237-8273.

What is Jerry T. Davis D.O.,p.A.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Jerry T. Davis D.O.,p.A. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2198382) is associated with this NPI, valid through November 1, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jerry T. Davis D.O.,p.A. was last updated on October 17, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.