Individual
HERBERT P EDMUNDSON JR.
Active
Individual
HERBERT P EDMUNDSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PHD
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
G8091
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10014684
AMERIGROUP
TX
05
—
119018302
—
TX
01
—
130010537
RAILROAD MEDICARE
TX
01
—
29055
TEXAN PLUS
TX
01
—
375890300
DEPT OF LABOR
TX
01
—
4105221
AETNA
TX
01
—
871313
BLUE CROSS BLUE SHIELD
TX
01
—
ED0871313
BCBS OUT OF STATE
—
01
—
MDG8091
W/C
TX
Enumeration date
05/15/2006
Last updated
02/07/2012
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