Provider Demographics
NPI:1588714851
Name:BARTSCH, EDWARD FRED (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:FRED
Last Name:BARTSCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77492-0146
Mailing Address - Country:US
Mailing Address - Phone:281-391-3185
Mailing Address - Fax:281-391-3749
Practice Address - Street 1:5207 E 5TH ST
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-2119
Practice Address - Country:US
Practice Address - Phone:281-391-3185
Practice Address - Fax:281-391-3749
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD0043208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B5900OtherBLUE CROSS BLUE SHIELD TX
TX8348N0Medicare ID - Type Unspecified
TX8B5900OtherBLUE CROSS BLUE SHIELD TX