Etheredge, Wade

Etheredge, Wade is an individual health care provider with primary practice located at 2400 Round Rock Ave , Round Rock TX 78681-4004. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medical Services is his primary health care specialty. Etheredge, Wade can be contacted via phone (512) 341-1000.

Contact Information

Primary practice address
2400 Round Rock Ave Round Rock TX 78681-4004
Phone: (512) 341-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X J1992 Texas
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X J1992 Texas

Profile Details

NPI number 1801854500
LBN Legal business name Etheredge, Wade
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 2nd, 2006
Last updated May 13th, 2010 - about 16 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 1801854500 NPPES
Texas MEDICAID 104414104

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