Organization
MEDICAL EDGE HEALTHCARE GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLAY HEIGHTEN MD (PRESIDENT)
(972) 739-3001
Entity
Organization
Contact information
Practice address
399 MELROSE DR STE A, RICHARDSON, TX 75080-4415
(972) 234-2000
(972) 421-4676
Mailing address
399 MELROSE DR STE A, RICHARDSON, TX 75080-4415
(972) 234-2000
(972) 421-4676
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
L05688
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
081500316
—
TX
Enumeration date
07/16/2006
Last updated
10/21/2010
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