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General NPI Number Information
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NPI Number | 1811987472
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Entity Type | Individual
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Provider Name | THOMAS W EDWARDS M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/25/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3636 S ALAMEDA ST LEVEL II, STE A
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City | CORPUS CHRISTI
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State | TX
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Zip | 78411-1723
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Country | US
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Telephone | 361-814-7246
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Fax | 361-814-7009
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Provider Business Mailing Address
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Address Line | 4549 RIVER PARK DR
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City | CORPUS CHRISTI
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State | TX
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Zip | 78410-5672
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Country | US
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Telephone | 361-814-7246
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Fax | 361-814-7009
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | G2690
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License Number State | TX
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