Provider Demographics
NPI:1720268741
Name:ADAMS, MOFFATT DAVID JR (DPM)
Entity type:Individual
Prefix:DR
First Name:MOFFATT
Middle Name:DAVID
Last Name:ADAMS
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19141 STONE OAK PKWY STE 104
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3367
Mailing Address - Country:US
Mailing Address - Phone:210-497-4642
Mailing Address - Fax:210-495-7245
Practice Address - Street 1:16607 BLANCO RD STE 12205
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1963
Practice Address - Country:US
Practice Address - Phone:210-497-4642
Practice Address - Fax:210-314-1375
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-07
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1845213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery