Provider Demographics
NPI:1558622910
Name:CAUTHON, DAVID JOSEPH (DPM)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JOSEPH
Last Name:CAUTHON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5825 CALLAGHAN RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1106
Mailing Address - Country:US
Mailing Address - Phone:210-227-8700
Mailing Address - Fax:210-348-9130
Practice Address - Street 1:9150 HUEBNER RD STE 160
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1545
Practice Address - Country:US
Practice Address - Phone:210-561-7080
Practice Address - Fax:210-561-7040
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-01
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2153213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8FE304OtherBCBS
TX416069ZJYHMedicare PIN