Provider Demographics
NPI:1285691006
Name:KREMER, EDWARD NORRIS (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:NORRIS
Last Name:KREMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:571 W MAIN ST STE 120
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-3667
Mailing Address - Country:US
Mailing Address - Phone:972-436-7531
Mailing Address - Fax:972-436-6114
Practice Address - Street 1:571 W MAIN ST STE 120
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-3667
Practice Address - Country:US
Practice Address - Phone:972-436-7531
Practice Address - Fax:972-436-6114
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8643207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB24115Medicare UPIN