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NPI Code Detail

MEDICARE: DR. MICHAEL T. EDMOND M.D.

MEDICARE: DR. MICHAEL T. EDMOND M.D.
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
1207R00000XInternal Medicine PhysicianE6071TX
22084N0400XNeurology PhysicianE6071TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649257452
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL T. EDMOND M.D.
Provider Business Mailing Address
First Line : PO BOX 26726
Second Line :
City : AUSTIN
State : TX
Zip : 78755-0726
Country : US
Telephone Number : 512-407-8686
Fax Number : 512-421-4489
Provider Business Practice Location Address
First Line : 6835 AUSTIN CENTER BLVD
Second Line :
City : AUSTIN
State : TX
Zip : 78731-3166
Country : US
Telephone Number : 512-346-6611
Fax Number : 512-231-5201
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2005
Last Update Date : 06/30/2010

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Directions to “ DR. MICHAEL T. EDMOND M.D.” Practice Location

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