Individual
DR. COLLEEN D EDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8355 WALNUT HILL LN STE 105, DALLAS, TX 75231-4242
(213) 368-3659
(214) 739-8923
Mailing address
8355 WALNUT HILL LN STE 105, DALLAS, TX 75231-4242
(213) 368-3659
(214) 739-8923
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2016013259
MO
208000000X
Pediatrics Physician
Primary
R3502
TX
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
2016013259
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IL
Enumeration date
07/23/2013
Last updated
10/02/2018
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