Edwards, Ricky D
Edwards, Ricky D is an individual health care provider with primary practice located at 1223 S Main St , Fort Worth TX 76104-4804. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Edwards, Ricky D can be contacted via phone (817) 702-7314.Contact Information
Primary practice address
1223 S Main St
Fort Worth TX 76104-4804
Phone: (817) 702-7314
Fax: (817) 702-7315
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | E8450 | Texas |
Profile Details
| NPI number | 1457358699 |
|---|---|
| LBN Legal business name | Edwards, Ricky D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 1st, 2005 |
| Last updated | Dec 4th, 2012 - about 12 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 | 1457358699 | NPPES |
| Texas | MEDICAID | 1285553-05 |
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