Provider Demographics
NPI:1972629624
Name:THOMAS W. EDWARDS, M.D., LTD, LLP
Entity type:Organization
Organization Name:THOMAS W. EDWARDS, M.D., LTD, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-814-7246
Mailing Address - Street 1:4918 HOLLY RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4755
Mailing Address - Country:US
Mailing Address - Phone:361-814-7246
Mailing Address - Fax:361-814-7009
Practice Address - Street 1:4918 HOLLY RD
Practice Address - Street 2:SUITE B
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4755
Practice Address - Country:US
Practice Address - Phone:361-814-7246
Practice Address - Fax:361-814-7009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2690207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0085KYOtherBLUE CROSS BLUE SHIELD
TX00416YMedicare ID - Type Unspecified