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Organization
MEDICAL EDGE HEALTHCARE GROUP PA
Active
Organization
MEDICAL EDGE HEALTHCARE GROUP PA
Active
Other names
Town East Mammography
Organization subpart
No
Provider details
NPI number
Authorized official
CLAY HEIGHTEN MD (PRESIDENT)
(972) 739-3001
Entity
Organization
Contact information
Practice address
1645 N TOWN EAST BLVD STE 503, MESQUITE, TX 75150-4147
(972) 686-3901
(972) 686-3985
Mailing address
1645 N TOWN EAST BLVD STE 503, MESQUITE, TX 75150-4147
(972) 686-3901
(972) 686-3985
Taxonomy
Speciality
Code
Description
License number
State
261QR0206X
Mammography Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
081500315
—
TX
Enumeration date
12/12/2006
Last updated
09/09/2008
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