Organization
MEDICAL EDGE HEALTHCARE GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLAY HEIGHTEN M.D. (PRESIDENT)
(972) 739-3001
Entity
Organization
Contact information
Practice address
6957 W PLANO PKWY STE 1300, PLANO, TX 75093-1621
(972) 820-1400
(214) 820-1020
Mailing address
PO BOX 650268, DALLAS, TX 75265-0268
(888) 238-9671
Taxonomy
Speciality
Code
Description
License number
State
261QX0203X
Radiation Oncology Clinic/Center
Primary
R31452
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200384001
—
TX
Enumeration date
06/04/2006
Last updated
09/29/2011
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