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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629310610
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDDIE DAVIS, DPM, PLLC

Provider Business Mailing Address
First Line	:	109 GALLERY CIR STE 119
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-3328
Country	:	US
Telephone Number	:	210-829-8770
Fax Number	:	210-495-0242

Provider Business Practice Location Address
First Line	:	1314 E SONTERRA BLVD STE 2103
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4286
Country	:	US
Telephone Number	:	210-829-8770
Fax Number	:	210-495-0242

Authorized Official
Title or Position	:	OWNER/DPM
Name	:	EDDIE DAVIS
Credential	:
Telephone Number	:	210-490-3668

Provider Enumeration Date	:	03/18/2013
Last Update Date	:	02/26/2025

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Directions to “EDDIE DAVIS, DPM, PLLC ” Practice Location

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