| Duwayne P. Edge, P.a. | |
|
2605 Amarillo Ingleside TX 78362-5710 | |
| (361) 775-0961 | |
| (361) 775-0960 |
| Full Name | Duwayne P. Edge, P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 2605 Amarillo, Ingleside, Texas |
| Authorized Official Name and Position | Duwayne Paul Edge (PRESIDENT) |
| Authorized Official Contact | 3617750961 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Duwayne P. Edge, P.a. P.o. Box 1507 Ingleside TX 78362-1507 Ph: (361) 775-0961 | Duwayne P. Edge, P.a. 2605 Amarillo Ingleside TX 78362-5710 Ph: (361) 775-0961 |
| NPI Number | 1235450404 |
|---|---|
| Provider Enumeration Date | 06/22/2010 |
| Last Update Date | 06/22/2010 |
| Medicare PECOS PAC ID | 0941331110 |
|---|---|
| Medicare Enrollment ID | O20100702000023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235450404 | NPI | - | NPPES |
| 101248603 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | J6416 (Texas) | Primary |
| Provider Name | Duwayne P Edge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730152612 PECOS PAC ID: 8022149343 Enrollment ID: I20100701000138 |
South Texas Health Alliance, Pllc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2582 Main St Ste B, Ingleside, TX 78362 Phone: 361-389-3234 | |
Ingleside Medical & Aesthetics Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2681 Hwy 361, Ingleside, TX 78362 Phone: 361-776-3500 Fax: 866-766-2629 | |
Wellmed Medical Group Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2713 Main St, Ingleside, TX 78362 Phone: 361-776-5107 Fax: 361-776-5136 | |
Texas Spine & Rehab Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2560 State Highway 361, Ingleside, TX 78362 Phone: 361-776-0030 Fax: 361-776-0731 |