Brandecker, Edward John

Brandecker, Edward John is an individual health care provider with primary practice located at 1888 Antilley Rd , Abilene TX 79606-5205. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Other Service Providers / Specialist. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is his primary health care specialty. Brandecker, Edward John can be contacted via phone (325) 795-9550.

Contact Information

Primary practice address
1888 Antilley Rd Abilene TX 79606-5205
Phone: (325) 795-9550
Fax: (325) 795-9537
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X J2508 Texas
Other Service Providers / Specialist 174400000X J2508 Texas

Profile Details

NPI number 1992700413
LBN Legal business name Brandecker, Edward John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2005
Last updated Sep 25th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992700413 NPPES
Other 4223641 AETNA
Other 8X7151 AETNA
MEDICAID 102408501 AETNA
Other 109067104 AETNA
Other 81T422 AETNA
Other 102408503 AETNA
Other 109067100 AETNA
Other CR1046 AETNA
Other 250003414 AETNA

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