Individual
MR. LARRY EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2200 W ILLINOIS AVE, MIDLAND, TX 79701-6407
(432) 570-1421
(432) 570-1427
Mailing address
PO BOX 5500, MIDLAND, TX 79704-5500
(432) 570-1421
(432) 570-1427
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
K5518
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84753R
SWMI BCBS PROV #
TX
Enumeration date
02/23/2006
Last updated
04/14/2008
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