Provider Demographics
NPI:1992509764
Name:EDGE MEDICAL SERVICES
Entity type:Organization
Organization Name:EDGE MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:BECKERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-348-4623
Mailing Address - Street 1:1141 N LOOP 1604 E # 105187
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1339
Mailing Address - Country:US
Mailing Address - Phone:830-203-2618
Mailing Address - Fax:
Practice Address - Street 1:4471A OPANA PL
Practice Address - Street 2:
Practice Address - City:HAIKU
Practice Address - State:HI
Practice Address - Zip Code:96708-5385
Practice Address - Country:US
Practice Address - Phone:800-348-4623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-02
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing