Edgin, Wendell Alan

Edgin, Wendell Alan is an individual health care provider with primary practice located at 4499 Medical Dr Suite 190, San Antonio TX 78229-3735. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Edgin, Wendell Alan can be contacted via phone (210) 614-3916.

Contact Information

Primary practice address
4499 Medical Dr Suite 190 San Antonio TX 78229-3735
Phone: (210) 614-3916
Fax: (210) 614-3918
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 12355 Texas

Profile Details

NPI number 1619977493
LBN Legal business name Edgin, Wendell Alan
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 22nd, 2005
Last updated Feb 28th, 2008 - about 18 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 1619977493 NPPES
Texas MEDICAID 141763601
Texas MEDICAID 141763604

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