MEDICARE: MR. EDWARD ALLEN MORGAN MD

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
1	207VG0400X	Gynecology Physician	G3622	TX

General Provider Information

NPI Number	:	1861493751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EDWARD ALLEN MORGAN MD

Provider Business Mailing Address
First Line	:	1910 W 35TH ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78703-1324
Country	:	US
Telephone Number	:	512-454-0405
Fax Number	:	512-454-0050

Provider Business Practice Location Address
First Line	:	1910 W 35TH ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78703-1324
Country	:	US
Telephone Number	:	512-454-0405
Fax Number	:	512-454-0050

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	07/08/2007

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