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NPI Code Detail

MEDICARE: MEDICAL EDGE HEALTHCARE GROUP PA

MEDICARE: MEDICAL EDGE HEALTHCARE GROUP PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QS1200XSleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number : 1326061904
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDICAL EDGE HEALTHCARE GROUP PA
Provider Business Mailing Address
First Line : 9229 LYNDON B JOHNSON FWY
Second Line : SUITE 250
City : DALLAS
State : TX
Zip : 75243-3405
Country : US
Telephone Number : 972-739-3637
Fax Number : 972-739-2673
Provider Business Practice Location Address
First Line : 500 N VALLEY PKWY
Second Line : SUITE 101
City : LEWISVILLE
State : TX
Zip : 75067-3437
Country : US
Telephone Number : 972-434-6600
Fax Number : 972-219-5277
Authorized Official
Title or Position : PRESIDENT
Name : CLAY HEIGHTEN
Credential : MD
Telephone Number : 972-739-3001
Provider Enumeration Date : 07/25/2006
Last Update Date : 08/22/2020

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