Dr. John Edeen III
Pediatric Orthopaedic Surgeon
4499 Medical Dr Suite 235
San Antonio
, Texas 78229-3735
Dr. John Edeen III
Pediatric Orthopaedic Surgeon
4499 Medical Dr Suite 235
San Antonio
, Texas 78229-3735
(210) 616-0290
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About
Features
Specialties
- Pediatric Orthopaedic Surgeon
Languages spoken
- English
Location
First Address
- Dr. John Edeen III
- 4499 Medical Drive Suite 235
- San Antonio, TX
- Zip : 78229-3712
- Fax : (210) 616-0290
- Phone : (210) 692-1613
Second Address
- Dr. John Edeen III
- 4499 Medical Dr Suite 235
- San Antonio, TX
- Zip : 78229-3735
- Fax : (210) 616-0290
- Phone : (210) 692-1613
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207XP3100X | Pediatric Orthopaedic Surgeon | K3719 | TX |
National Provider Identifier
| NPI | 1972578565 |
|---|---|
| Provider Name | Dr. John Edeen III |
| First Address | San Antonio, TX 78229-3712 |
| Second Address | San Antonio, TX 78229-3735 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/02/2006 |
| Last Update Date | 22/08/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 048514602 | (05) | TX |
| 048514602 | TPI (01) | TX |
| F96389 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.