Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 1261077 | TX |
NPI | 1023668084 |
---|---|
Provider Name | Brushie Arnell Edwards |
First Address | Mckinney, TX 75071-6331 |
Second Address | Mckinney, TX 75071-6331 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2019 |
Last Update Date | 12/09/2019 |