Healthcare Provider Details

I. General information

NPI: 1356256523
Provider Name (Legal Business Name): EDGE MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

467 SUNSET DR
JORDAN MN
55352-1629
US

IV. Provider business mailing address

1141 N LOOP 1604 E STE 105-187
SAN ANTONIO TX
78232-1339
US

V. Phone/Fax

Practice location:
  • Phone: 210-464-3611
  • Fax: 888-329-2091
Mailing address:
  • Phone: 210-464-3611
  • Fax: 888-329-2091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FAITH BLEVINS
Title or Position: ADMIN
Credential:
Phone: 210-464-3611