Organization
EDGE-MD HOLDING PLLC
Active
Other names
Medico MD
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA CARRILLO (MANAGER)
(512) 920-3107
Entity
Organization
Contact information
Practice address
1200 W WALNUT HILL LN STE 1300, IRVING, TX 75038-3050
(972) 514-1672
Mailing address
1200 W WALNUT HILL LN STE 1300, IRVING, TX 75038-3050
(972) 514-1672
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Enumeration date
10/30/2018
Last updated
10/30/2018
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