De La Fuente, Edgar
De La Fuente, Edgar is an sole proprietor health care provider with primary practice located at 719 N. Second Street , Longview TX 75601-5316. He recently has only one registered license in Suppliers / Prosthetic/Orthotic Supplier, which is considered as his primary health care specialty. De La Fuente, Edgar can be contacted via phone (903) 553-1040.Contact Information
Primary practice address
719 N. Second Street
Longview TX 75601-5316
Phone: (903) 553-1040
Fax: (903) 553-9996
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Prosthetic/Orthotic Supplier | 335E00000X | 233 | Texas |
Profile Details
| NPI number | 1750323713 |
|---|---|
| LBN Legal business name | De La Fuente, Edgar |
| Credentials | LICENSED PROSTHETIST |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 12th, 2006 |
| Last updated | Mar 18th, 2015 - about 9 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 | 1750323713 | NPPES |
| Texas | Other | 1750323713 | NPI |
| Texas | Other | 531976 | NPI |
| Texas | MEDICAID | 168459901 | NPI |
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