Organization
EDDIE DAVIS DPM PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSALIE KREIGHBAUM (REGIONAL CREDENTIALING SPECIALIST)
(314) 909-1920
Entity
Organization
Contact information
Practice address
109 GALLERY CIR STE 119, SAN ANTONIO, TX 78258-3328
(210) 490-3668
Mailing address
PO BOX 825159, PHILADELPHIA, PA 19182-5159
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
06/04/2025
Last updated
06/04/2025
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