Individual
MR. EDGAR DE LA FUENTE
Active
Individual
MR. EDGAR DE LA FUENTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICENSED PROSTHETIST
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
233
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168459901
—
TX
01
—
1750323713
NPI
TX
01
—
531976
BCBS OF TEXAS
TX
Enumeration date
06/12/2006
Last updated
04/17/2026
Update your record
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