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General NPI Number Information
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NPI Number | 1134192974
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Entity Type | Individual
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Provider Name | FLORA EDISON MD
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Gender | Female
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Dates
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Enumeration Date | 02/10/2006
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Last Update Date | 10/13/2015
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Provider Practice Location Address
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Address Line | 902 REBEL RD
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City | KYLE
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State | TX
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Zip | 78640-9478
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Country | US
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Telephone | 512-268-2613
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Fax | 512-268-2615
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Provider Business Mailing Address
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Address Line | 902 REBEL RD
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City | KYLE
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State | TX
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Zip | 78640-9478
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Country | US
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Telephone | 512-268-2613
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Fax | 512-268-2615
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | L3539
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License Number State | TX
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