Individual
MR. EDWARD L. RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
720 PLEASANTON RD, SAN ANTONIO, TX 78214-1306
(210) 921-3800
(210) 334-2851
Mailing address
720 PLEASANTON RD, SAN ANTONIO, TX 78214-1306
(210) 921-3800
(210) 334-2861
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01214
TX
Other
Enumeration date
09/02/2006
Last updated
01/12/2015
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