MEDICARE: EDWARD K TSE 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
1	207R00000X	Internal Medicine Physician	G4413	TX
2	208D00000X	General Practice Physician	G4413	TX
3	207Q00000X	Family Medicine Physician	G4413	TX

General Provider Information

NPI Number	:	1881692531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWARD K TSE M.D.

Provider Business Mailing Address
First Line	:	9129 MESA DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77028-1606
Country	:	US
Telephone Number	:	713-633-8450
Fax Number	:	713-633-5079

Provider Business Practice Location Address
First Line	:	9129 MESA DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77028-1606
Country	:	US
Telephone Number	:	713-633-8450
Fax Number	:	713-633-5079

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	12/18/2007

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