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General NPI Number Information
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NPI Number | 1811217367
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Entity Type | Organization
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Legal Business Name | TED L EDWARDS JR MD PA
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Dates
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Enumeration Date | 06/07/2010
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Last Update Date | 02/16/2016
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Provider Practice Location Address
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Address Line | 4201 BEE CAVES RD
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City | WEST LAKE HILLS
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State | TX
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Zip | 78746-6465
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Country | US
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Telephone | 512-327-4886
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Fax | 512-327-4958
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Provider Business Mailing Address
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Address Line | 4201 BEE CAVES RD
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City | WEST LAKE HILLS
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State | TX
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Zip | 78746-6465
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Country | US
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Telephone | 512-327-4886
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Fax | 512-327-4958
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Authorized Official
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Title or Position | OWNER
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Name | DR. TED L EDWARDS JR.
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Credential | MD
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Telephone | 512-327-4886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | C8269
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License Number State | TX
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