Edeen, John

Edeen, John is an individual health care provider with primary practice located at 4499 Medical Dr Suite 235, San Antonio TX 78229-3735. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Orthopaedic Surgery, which is considered as his primary health care specialty. Edeen, John can be contacted via phone (210) 692-1613.

Contact Information

Primary practice address
4499 Medical Dr Suite 235 San Antonio TX 78229-3735
Phone: (210) 692-1613
Fax: (210) 616-0290
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Orthopaedic Surgery 207XP3100X K3719 Texas

Profile Details

NPI number 1972578565
LBN Legal business name Edeen, John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2006
Last updated Aug 22nd, 2011 - 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 1972578565 NPPES
Texas Other 048514602 TPI
Texas MEDICAID 048514602 TPI

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