Individual
DR. WHITNEY BRANT EDMISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
(702) 384-1815
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-8800
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
11819
NV
2085R0202X
Diagnostic Radiology Physician
44175
MN
2085R0202X
Diagnostic Radiology Physician
Primary
P2638
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417929779
—
CA
05
—
1417929779
—
NV
05
—
200470210A
—
OK
05
—
502432300
—
MN
01
—
P01168981
RR MEDICARE
NV
Enumeration date
02/02/2006
Last updated
09/10/2020
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