Healthcare Provider Details

I. General information

NPI: 1174490924
Provider Name (Legal Business Name): EDDIE DAVIS DPM PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2025
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12000 RICHMOND AVE STE 370
HOUSTON TX
77082-2964
US

IV. Provider business mailing address

PO BOX 825159
PHILADELPHIA PA
19182-5159
US

V. Phone/Fax

Practice location:
  • Phone: 281-531-4100
  • Fax: 281-531-9600
Mailing address:
  • Phone: 866-626-1540
  • Fax: 866-386-8526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: SERGIO ZAPICO
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 210-970-8010