Healthcare Provider Details

I. General information

NPI: 1275867640
Provider Name (Legal Business Name): ALEXIS N DAVIS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXIS JOHNSON

II. Dates (important events)

Enumeration Date: 10/01/2009
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 DATAPOINT DR SUITE 500
SAN ANTONIO TX
78229-5900
US

IV. Provider business mailing address

8401 DATAPOINT DR SUITE 500
SAN ANTONIO TX
78229-5900
US

V. Phone/Fax

Practice location:
  • Phone: 210-614-0180
  • Fax: 210-566-5698
Mailing address:
  • Phone: 210-614-0180
  • Fax: 210-615-7170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: