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Organization
MEDICAL EDGE HEALTHCARE GROUP PA
Active
Organization
MEDICAL EDGE HEALTHCARE GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLAY M. HEIGHTEN M.D. (PRESIDENT)
(972) 739-3001
Entity
Organization
Contact information
Practice address
9229 LYNDON B JOHNSON FWY STE 250, DALLAS, TX 75243-4403
(972) 739-3001
Mailing address
9229 LYNDON B JOHNSON FWY STE 250, DALLAS, TX 75243-4403
(972) 739-3001
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
NULL
111N00000X
Chiropractor
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
NULL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
NULL
207RH0003X
Hematology & Oncology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
NULL
2085R0202X
Diagnostic Radiology Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
261QR0200X
Radiology Clinic/Center
—
NULL
363AM0700X
Medical Physician Assistant
—
NULL
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0046AZ
BCBS
TX
01
—
00516N
BCBS
TX
01
—
0099BH
BCBS
TX
05
—
081500301
—
TX
05
—
081500302
—
TX
05
—
081500315
—
TX
05
—
081500316
—
TX
05
—
186985101
—
TX
05
—
186985102
—
TX
05
—
186985103
—
TX
05
—
200384001
—
TX
Enumeration date
05/18/2006
Last updated
09/16/2011
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