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General NPI Number Information
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NPI Number | 1760582126
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Entity Type | Organization
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Legal Business Name | MEDICAL EDGE HEALTHCARE GROUP PA
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 08/04/2008
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Provider Practice Location Address
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Address Line | 6300 W PARKER RD STE 420
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City | PLANO
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State | TX
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Zip | 75093-8134
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Country | US
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Telephone | 972-981-7900
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Fax | 972-981-7781
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Provider Business Mailing Address
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Address Line | 6300 W PARKER RD STE 420
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City | PLANO
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State | TX
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Zip | 75093-8134
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Country | US
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Telephone | 972-981-7900
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Fax | 972-981-7781
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Authorized Official
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Title or Position | PRESIDENT
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Name | CLAY HEIGHTEN
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Credential | MD
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Telephone | 972-739-3001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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