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Organization
MIAP, PC
Active
Organization
MIAP, PC
Active
Other names
Seagoville Family Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD L GELBER P.A. (PHYSICAL ASSISTANT)
(972) 287-7474
Entity
Organization
Contact information
Practice address
116 HALL RD, SEAGOVILLE, TX 75159-2916
(972) 287-7474
(972) 287-7464
Mailing address
116 HALL RD, SEAGOVILLE, TX 75159
(972) 287-7474
(972) 287-7464
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0072NH
BLUECROSSBLUESHIELD GROUP
TX
05
—
178739201
—
TX
05
—
178739202
—
TX
01
—
45D1024097
CLIA
TX
01
—
DE6386
RAILROAD MEDICARE
TX
Enumeration date
08/19/2006
Last updated
10/06/2008
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