Healthcare Provider Details

I. General information

NPI: 1861493751
Provider Name (Legal Business Name): EDWARD ALLEN MORGAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 W 35TH ST
AUSTIN TX
78703-1324
US

IV. Provider business mailing address

1910 W 35TH ST
AUSTIN TX
78703-1324
US

V. Phone/Fax

Practice location:
  • Phone: 512-454-0405
  • Fax: 512-454-0050
Mailing address:
  • Phone: 512-454-0405
  • Fax: 512-454-0050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberG3622
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: