Edgar Bedolla
Surgeon Plastic and Reconstructive Surgery
415 E Southlake Blvd Ste 202
Southlake
, Texas 76092
Edgar Bedolla
Surgeon Plastic and Reconstructive Surgery
415 E Southlake Blvd Ste 202
Southlake
, Texas 76092
(817) 416-8080
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About
Features
Specialties
- Surgeon
- Plastic and Reconstructive Surgery
Languages spoken
- English
Location
First Address
- Edgar Bedolla
- 415 E Southlake Blvd Ste 202
- Southlake, TX
- Zip : 76092-6280
- Phone : (817) 416-8080
Second Address
- Edgar Bedolla
- 415 E Southlake Blvd Ste 202
- Southlake, TX
- Zip : 76092
- Phone : (817) 416-8080
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208200000X | Surgeon | 27188 | OK |
| N | 208600000X | Surgeon | 27188 | OK |
| Y | 2086S0122X | Plastic and Reconstructive Surgery | R7662 | TX |
National Provider Identifier
| NPI | 1265691158 |
|---|---|
| Provider Name | Edgar Bedolla |
| First Address | Southlake, TX 76092-6280 |
| Second Address | Southlake, TX 76092 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/06/2008 |
| Last Update Date | 25/08/2018 |
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.