Individual
MARY E EDGERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
M4769
TX
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
ME95161
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194617001 (MDACC)
—
TX
05
—
274876200
—
FL
01
—
41050
BLUE CROSS BLUE SHIELD
FL
01
—
8S2503
BCBS (MDACC)
TX
Enumeration date
07/12/2006
Last updated
07/30/2012
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