Edwards, Victa Jeron

Edwards, Victa Jeron is an individual health care provider with primary practice located at 1801 Merlin St , Bay City TX 77414-3131. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Edwards, Victa Jeron can be contacted via phone (979) 323-8400.

Contact Information

Primary practice address
1801 Merlin St Bay City TX 77414-3131
Phone: (979) 323-8400
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 18764 Texas

Profile Details

NPI number 1003976747
LBN Legal business name Edwards, Victa Jeron
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 11th, 2006
Last updated May 1st, 2013 - about 11 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 1003976747 NPPES
Texas Other B18764-01 CHIP
Texas MEDICAID 1333247-12 CHIP

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