Individual
MILES DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12342 MAGNOLIA SPG, SAN ANTONIO, TX 78253-6381
(210) 376-0319
Mailing address
12342 MAGNOLIA SPG, SAN ANTONIO, TX 78253-6381
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
374700000X
Technician
Primary
—
—
Other
Enumeration date
01/23/2025
Last updated
06/17/2026
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