MEDICARE: EDDIE DAVIS DPM PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	213E00000X	Podiatrist
3	213ES0103X	Foot & Ankle Surgery Podiatrist

General Provider Information

NPI Number	:	1174490924
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDDIE DAVIS DPM PLLC

Provider Business Mailing Address
First Line	:	PO BOX 825159
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19182-5159
Country	:	US
Telephone Number	:	866-626-1540
Fax Number	:	866-386-8526

Provider Business Practice Location Address
First Line	:	12000 RICHMOND AVE STE 370
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-2964
Country	:	US
Telephone Number	:	281-531-4100
Fax Number	:	281-531-9600

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	SERGIO ZAPICO
Credential	:
Telephone Number	:	210-970-8010

Provider Enumeration Date	:	10/17/2025
Last Update Date	:	10/17/2025

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