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NPI Code Detail

MEDICARE: DR. DEBORAH YORK EDWARDS DPT

MEDICARE: DR. DEBORAH YORK EDWARDS DPT
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
1225100000XPhysical Therapist1163617TX
22251X0800XOrthopedic Physical Therapist06568RLA
32251X0800XOrthopedic Physical Therapist1163617TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11163617OTHERTXTEXAS PT LICENSURE

General Provider Information

NPI Number : 1932329299
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEBORAH YORK EDWARDS DPT
Provider Business Mailing Address
First Line : 8216 SAN DIEGO ST
Second Line :
City : ODESSA
State : TX
Zip : 79765-8523
Country : US
Telephone Number : 504-491-4217
Fax Number :
Provider Business Practice Location Address
First Line : 3003 N A ST
Second Line :
City : MIDLAND
State : TX
Zip : 79705-5304
Country : US
Telephone Number : 432-684-7755
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2007
Last Update Date : 12/06/2021

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