Individual
ROBERT E EDMONSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
221 W COLORADO BLVD, STE 625, DALLAS, TX 75208-2363
(214) 946-5165
(214) 946-4876
Mailing address
221 W COLORADO BLVD, STE 625, DALLAS, TX 75208-2363
(214) 946-5165
(214) 946-4876
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
D0861
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060036498
RAILROAD MEDICARE
TX
05
—
122747203
—
TX
01
—
88K978
BLUE CROSS BLUE SHIELD
TX
Enumeration date
06/15/2006
Last updated
09/18/2014
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