Individual
DR. DUWAYNE PAUL EDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2605 AMARILLO ST, INGLESIDE, TX 78362-5710
(361) 775-0961
Mailing address
2605 AMARILLO ST, INGLESIDE, TX 78362-5710
(361) 775-0961
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J6416
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101248603
—
TX
Enumeration date
02/09/2006
Last updated
10/06/2016
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