Broad, Edward Richard
Broad, Edward Richard is an individual health care provider with primary practice located at 611 W Brown St #101, Wylie TX 75098. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Broad, Edward Richard can be contacted via phone (972) 442-5287.Contact Information
Primary practice address
611 W Brown St #101
Wylie TX 75098
Phone: (972) 442-5287
Fax: (972) 442-3181
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 1152490 | Texas |
Profile Details
NPI number | 1235152117 |
---|---|
LBN Legal business name | Broad, Edward Richard |
Credentials | Master of Physical Therapy (MPT) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 25th, 2006 |
Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1235152117 | NPPES |
Other | 0021MG | BCBS GRP | |
Other | P00223957 | BCBS GRP | |
Other | DD3715 | BCBS GRP | |
Other | 8T3999 | BCBS GRP |
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