Edmondson, Steven Ray
Edmondson, Steven Ray is an sole proprietor health care provider with primary practice located at 3025 N Tarrant Pkwy Suite 240, Fort Worth TX 76177-8620. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gynecology, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Obstetrics. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is his primary health care specialty. Edmondson, Steven Ray can be contacted via phone (817) 431-1500.Contact Information
Primary practice address
3025 N Tarrant Pkwy Suite 240
Fort Worth TX 76177-8620
Phone: (817) 431-1500
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | G8830 | Texas |
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | G8830 | Texas |
| Allopathic & Osteopathic Physicians / Obstetrics | 207VX0000X | G8830 | Texas |
Profile Details
| NPI number | 1164429890 |
|---|---|
| LBN Legal business name | Edmondson, Steven Ray |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 7th, 2005 |
| Last updated | Oct 15th, 2016 - 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 | 1164429890 | NPPES |
| Texas | MEDICAID | 131769510 | |
| Texas | Other | 83022Y | |
| Texas | MEDICAID | 131769508 | |
| Texas | MEDICAID | 109380901 | |
| Texas | MEDICAID | 131769502 | |
| Texas | MEDICAID | 131769509 | |
| Texas | Other | 0737147 | |
| Texas | Other | 2357545 |
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