Individual
MR. ROBERT W EDRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED.
Contact information
Practice address
201 S IH 35 STE B, NEW BRAUNFELS, TX 78130-4876
(830) 609-3438
(830) 609-3438
Mailing address
6609 BLANCO ROAD, SUITE 115, SAN ANTONIO, TX 78216-6131
(210) 342-2299
(210) 342-5499
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
51259
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1994675-01
—
TX
01
—
8K5237
MEDICARE INDIVIDUAL PTAN
TX
Enumeration date
12/24/2007
Last updated
07/21/2009
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