Individual
DR. MICHAEL T. EDMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6835 AUSTIN CENTER BLVD, AUSTIN, TX 78731-3166
(512) 346-6611
(512) 231-5201
Mailing address
PO BOX 26726, AUSTIN, TX 78755-0726
(512) 407-8686
(512) 421-4489
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
E6071
TX
2084N0400X
Neurology Physician
Primary
E6071
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130017527
—
TX
05
—
130204408
—
TX
05
—
130204409
—
TX
Enumeration date
12/22/2005
Last updated
06/30/2010
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