NPIMap

Organization Active NPI

Eddie Davis, DPM, PLLC

  • Podiatrist
  • San Antonio, TX
National Provider Identifier
1386793909
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
EDDIE DAVIS, DPM, PLLC
Practice address
7424 Broadway St
San Antonio, TX 78209-3254
Phone
(210) 829-8770
Fax
(210) 826-4864
NPI assigned
Jan 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Eddie DavisNPI 1609075902
Title
Owner/DPM
Phone
(210) 490-3668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X Primary
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

7424 Broadway St
San Antonio, TX 78209-3254

Mailing address

109 Gallery Cir Ste 119
San Antonio, TX 78258-3328
Phone (210) 829-8770

Other identifiers 1

IdentifierTypeStateIssuer
018792401MedicaidTX

Other names 1

  • Alamo Family Foot & Ankle Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050105000242 TX Part B Supplier - Clinic/Group Practice 5799752499 Receives reassigned benefits from 2 practitioners
Practice locations: San Antonio, TX
O20231117002845 TX DME Supplier - Physician - Podiatry 5991868291 Practice locations: San Antonio, TX

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Eddie Davis DPM PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7424 Broadway
San Antonio, TX 78209
Phone (210) 829-8770

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740528000000",
    "number": "1386793909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 GALLERY CIR STE 119",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583328",
            "telephone_number": "210-829-8770",
            "fax_number": "210-826-4864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7424 BROADWAY ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782093254",
            "telephone_number": "210-829-8770",
            "fax_number": "210-826-4864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDDIE DAVIS, DPM, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_title_or_position": "OWNER/DPM",
        "authorized_official_telephone_number": "210-490-3668"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018792401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alamo Family Foot & Ankle Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.