Active NPI 1497764260 Individual Practitioner Female Practitioner

Amy Lynn Edwards , PA-C

Physician Assistant • Waxahachie, TX

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Amy Edwards, PA-C is a certified Physician Assistant practicing in Waxahachie, TX. With approximately 26 years of clinical experience since completing medical education in 2000, Amy Edwards delivers high-quality medical care to the local community at 1405 W JEFFERSON ST.

Amy Edwards is affiliated with Oliver Street 5.01(A) Inc and accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1405 W Jefferson St

Waxahachie, TX 751652231

Telephone 9729237178

Associated Practice Facility / Clinic

🏢 Baylor Medical Center At Waxahachie Facility NPI 1750380507

Medicare Profile & Education

Medical School

Other

Graduation Year

2000

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Waxahachie, TX

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

26 Yrs +15.3 yrs vs City Avg

City Avg: 10.7 Yrs

State Avg: 13.9 Yrs

Regional Practice Density

23 Specialists

Practicing in Waxahachie, TX (11140 Statewide)

Telehealth Adoption Rate

8.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

79.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Edwards (26 Years) 26 Yrs

Waxahachie Specialty Average (10.7 Years) 10.7 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	4,130	592	$23.00	$5.47
99213 Established patient office or other outpatient visit, typically 15 minutes	1,684	965	$309.00	$75.68
17000 Destruction of skin growth	1,359	831	$231.00	$36.51
17110 Destruction of up to 14 skin growths	1,184	764	$388.00	$92.52
11102 Tangential biopsy of single skin lesion	489	386	$341.00	$61.34
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	276	228	$435.00	$106.63
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	140	140	$379.00	$92.81
17004 Destruction of precancer skin growth, 15 or more growths	133	75	$570.00	$138.39
11103 Biopsy of related skin growth, each additional growth	115	82	$171.00	$41.47
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	75	65	$1032.00	$246.49
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	69	64	$192.00	$47.01
11104 Punch biopsy, first skin growth	51	47	$425.00	$99.68
17111 Destruction of skin growth, 15 or more growths	45	32	$453.00	$107.14
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	42	33	$608.00	$141.11
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	37	33	$948.00	$115.76
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	31	31	$567.00	$139.75
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	28	27	$586.00	$71.21
69100 Biopsy of ear	27	26	$325.00	$58.50
11105 Punch biopsy, each additional skin growth	24	20	$203.00	$49.23
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	23	19	$894.00	$216.48
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	22	19	$643.00	$145.51
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	18	15	$833.00	$101.80
10061 Complicated or multiple drainage of skin abscess	17	13	$731.00	$178.90

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	3,876	540	$23.00	$5.53
99213 Established patient office or other outpatient visit, typically 15 minutes	1,617	963	$297.00	$74.52
17000 Destruction of skin growth	1,235	751	$223.00	$37.81
17110 Destruction of up to 14 skin growths	1,024	708	$378.00	$92.41
11102 Tangential biopsy of single skin lesion	449	375	$338.00	$63.89
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	200	181	$420.00	$105.40
17004 Destruction of precancer skin growth, 15 or more growths	171	100	$562.00	$139.94
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	141	141	$369.00	$91.92
11103 Biopsy of related skin growth, each additional growth	127	77	$168.00	$41.14
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	77	74	$186.00	$46.70
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	67	55	$1011.00	$239.02
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	52	38	$594.00	$131.13
17111 Destruction of skin growth, 15 or more growths	47	29	$441.00	$109.89
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	47	47	$547.00	$135.91
11104 Punch biopsy, first skin growth	45	45	$419.00	$104.21
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	32	17	$1275.00	$384.80
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	27	27	$927.00	$115.73
96574 Application of light with debridement to destroy precancer skin growth	27	17	$933.00	$232.21
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	27	24	$572.00	$69.95
10061 Complicated or multiple drainage of skin abscess	22	16	$705.00	$176.42
69100 Biopsy of ear	22	22	$321.00	$58.23
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	19	19	$878.00	$218.51
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	19	18	$627.00	$152.55
11105 Punch biopsy, each additional skin growth	17	16	$197.00	$44.85
10060 Simple or single drainage of skin abscess	13	13	$417.00	$96.07
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	12	11	$813.00	$101.49

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	3,720	489	$23.00	$5.66
99213 Established patient office or other outpatient visit, typically 15 minutes	1,358	854	$295.00	$75.03
17000 Destruction of skin growth	1,104	692	$221.00	$37.80
17110 Destruction of up to 14 skin growths	931	642	$374.00	$92.47
11102 Tangential biopsy of single skin lesion	519	419	$338.00	$64.94
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	380	315	$184.00	$46.80
17004 Destruction of precancer skin growth, 15 or more growths	141	85	$554.00	$141.26
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	135	122	$416.00	$106.20
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	132	132	$365.00	$92.21
11103 Biopsy of related skin growth, each additional growth	125	96	$169.00	$42.40
11104 Punch biopsy, first skin growth	70	69	$420.00	$105.79
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	51	47	$1000.00	$252.73
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	42	34	$587.00	$139.93
99202 New patient office or other outpatient visit, typically 20 minutes	34	34	$237.00	$59.84
69100 Biopsy of ear	29	28	$319.00	$64.54
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	29	29	$543.00	$135.23
11105 Punch biopsy, each additional skin growth	27	21	$196.00	$48.67
17111 Destruction of skin growth, 15 or more growths	26	18	$437.00	$108.86
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	26	25	$915.00	$121.30
10060 Simple or single drainage of skin abscess	24	23	$409.00	$104.47
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	22	18	$1275.00	$389.03
96574 Application of light with debridement to destroy precancer skin growth	20	18	$943.00	$241.14
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	17	13	$339.00	$63.44
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	17	16	$875.00	$215.72
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	16	15	$804.00	$102.43
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	15	14	$620.00	$152.67
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	14	12	$570.00	$72.33

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	3,398	498	$21.17	$5.50
99213 Established patient office or other outpatient visit, typically 15 minutes	1,184	790	$289.16	$76.30
17000 Destruction of skin growth	1,089	667	$212.78	$37.79
17110 Destruction of up to 14 skin growths	934	649	$365.49	$93.42
11102 Tangential biopsy of single skin lesion	565	458	$335.08	$68.30
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	421	346	$178.33	$47.01
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	251	221	$406.91	$108.36
11103 Biopsy of related skin growth, each additional growth	138	96	$171.04	$44.58
17004 Destruction of precancer skin growth, 15 or more growths	114	75	$529.74	$139.63
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	89	89	$358.16	$93.84
99202 New patient office or other outpatient visit, typically 20 minutes	56	56	$234.54	$60.21
11104 Punch biopsy, first skin growth	49	49	$419.19	$108.10
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	45	42	$995.02	$251.91
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	42	37	$574.54	$141.69
69100 Biopsy of ear	34	31	$319.09	$59.08
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	29	29	$536.00	$140.73
17111 Destruction of skin growth, 15 or more growths	25	16	$429.00	$112.26
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	25	24	$908.69	$123.53
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	22	21	$857.00	$223.73
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	22	21	$607.56	$155.72
11105 Punch biopsy, each additional skin growth	20	18	$196.99	$51.48
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	16	16	$800.00	$104.58
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	13	13	$560.00	$73.04
10060 Simple or single drainage of skin abscess	11	11	$398.00	$104.10

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	3,233	519	$17.42	$5.04
99213 Established patient office or other outpatient visit, typically 15 minutes	1,477	921	$175.54	$62.51
17000 Destruction of skin growth	1,073	725	$154.82	$37.24
17110 Destruction of up to 14 skin growths	791	591	$265.00	$91.39
11102 Tangential biopsy of single skin lesion	449	376	$229.67	$63.21
99202 New patient office or other outpatient visit, typically 20 minutes	156	156	$175.87	$62.84
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	144	129	$266.27	$90.29
11103 Biopsy of related skin growth, each additional growth	117	81	$121.58	$44.39
17004 Destruction of precancer skin growth, 15 or more growths	103	70	$371.39	$132.54
11104 Punch biopsy, first skin growth	63	59	$288.27	$105.07
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	50	47	$425.98	$136.34
69100 Biopsy of ear	37	32	$252.61	$61.20
11105 Punch biopsy, each additional skin growth	32	24	$130.86	$50.64
17111 Destruction of skin growth, 15 or more growths	30	25	$315.95	$106.93
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	23	22	$442.43	$157.06
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	21	21	$726.83	$240.24
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	16	16	$240.63	$86.96
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	16	16	$401.41	$149.34
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	16	14	$305.25	$99.10
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	15	14	$519.23	$172.69
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	14	14	$98.57	$37.75

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	3,857	597	$13.95	$4.55
99213 Established patient office or other outpatient visit, typically 15 minutes	1,583	1,042	$151.00	$60.48
17000 Destruction of skin growth	1,182	817	$133.00	$36.05
17110 Destruction of up to 14 skin growths	871	689	$226.00	$85.78
11102 Tangential biopsy of single skin lesion	641	536	$202.00	$63.15
99202 New patient office or other outpatient visit, typically 20 minutes	263	263	$155.00	$61.89
11103 Biopsy of related skin growth, each additional growth	161	123	$109.00	$43.01
17004 Destruction of precancer skin growth, 15 or more growths	134	94	$311.00	$123.70
11104 Punch biopsy, first skin growth	121	119	$254.00	$100.33
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	72	63	$361.00	$134.81
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	62	58	$221.00	$89.07
17111 Destruction of skin growth, 15 or more growths	44	32	$267.00	$104.46
69100 Biopsy of ear	43	40	$201.00	$57.69
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	41	35	$384.00	$149.30
11105 Punch biopsy, each additional skin growth	38	36	$125.00	$49.53
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	35	32	$92.00	$36.73
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	26	26	$220.00	$88.63
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	25	24	$623.00	$218.02
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	23	23	$367.00	$139.76
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	19	19	$503.00	$176.86
10060 Simple or single drainage of skin abscess	17	16	$243.00	$97.05
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	16	16	$345.00	$68.44
17271 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	16	16	$337.00	$104.67
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	16	13	$809.00	$389.74
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	15	14	$296.00	$109.91
96574 Application of light with debridement to destroy precancer skin growth	15	13	$523.00	$207.26
40490 Biopsy of lip	11	11	$259.00	$98.52

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,108	311	$37.39	$4.25
99213 Established patient office or other outpatient visit, typically 15 minutes	846	510	$105.36	$59.34
17000 Destruction of skin growth	682	416	$144.03	$34.52
11100 Biopsy of single growth of skin and/or tissue	510	381	$185.17	$67.09
17110 Destruction of up to 14 skin growths	490	349	$195.74	$87.93
11101 Biopsy of each additional growth of skin and/or tissue	182	124	$85.65	$26.64
99202 New patient office or other outpatient visit, typically 20 minutes	133	133	$116.66	$61.09
17004 Destruction of precancer skin growth, 15 or more growths	48	29	$377.20	$117.95
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	38	38	$156.42	$86.68
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	38	37	$68.50	$35.75
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	33	31	$312.27	$130.51
17111 Destruction of skin growth, 15 or more growths	32	18	$211.72	$107.61
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	28	28	$174.25	$86.02
69100 Biopsy of ear	24	22	$196.11	$54.73
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	15	14	$547.38	$215.53
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	15	15	$336.56	$147.50
40490 Biopsy of lip	11	11	$234.49	$105.79

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,140	347	$12.96	$4.44
99213 Established patient office or other outpatient visit, typically 15 minutes	879	545	$77.63	$58.10
17000 Destruction of skin growth	735	455	$79.13	$33.74
17110 Destruction of up to 14 skin growths	583	421	$122.81	$86.24
11100 Biopsy of single growth of skin and/or tissue	533	415	$109.63	$62.80
99202 New patient office or other outpatient visit, typically 20 minutes	216	216	$76.63	$59.18
11101 Biopsy of each additional growth of skin and/or tissue	157	115	$38.05	$25.99
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	83	79	$45.64	$34.31
17004 Destruction of precancer skin growth, 15 or more growths	59	41	$188.02	$119.35
17111 Destruction of skin growth, 15 or more growths	35	24	$129.51	$103.84
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	27	24	$183.03	$123.10
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	27	27	$112.12	$86.03
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	21	21	$106.65	$83.31
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	15	14	$145.68	$98.00
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	15	14	$200.49	$142.68
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	15	13	$231.60	$162.87
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	14	14	$179.64	$141.24

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License TX PA02832

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

281894003 (TX)

Medicaid State Provider ID

281894001 (TX)

Medicaid State Provider ID

281894002 (TX)

Commercial Insurance / Payer ID Physician Assistants

PA02832 (TX)

Hospital & Practice Group Affiliations

Oliver Street 5.01(A) Inc

1367 Dominion Plz, Tyler, TX 757031013

Phone: 9035346200

Oliver Street 5.01(A) Inc

910 Pecan Grove Rd E, Sherman, TX 750901770

Phone: 9038922126

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners

Vickie Kuhn , FNP

Nurse Practitioner

NPI 1437168242

Family Nurse Practitioner

Dr. Joseph D Addesio , MD

Emergency Medicine

NPI 1477562221

Doctor of Medicine (M.D.)

Brenda Rapp , FNP

Nurse Practitioner

NPI 1689683419

Family Nurse Practitioner

Dr. Derrick Owens , MD

Family Medicine

NPI 1831108661

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active October 17, 2011

NPI status registered as active in NPPES database

📍

Updated Practice Location October 17, 2011

Registered at 1405 W JEFFERSON ST, WAXAHACHIE, TX 751652231 (Tel: 9729237178)

📍

Updated Business Mailing Address October 17, 2011

Registered at 9125 CALVERT RD, LANTANA, TX 762266452 (Tel: 9729229561)

👤

Provider Name / Credentials Updated October 17, 2011

Recorded as AMY EDWARDS, PA-C

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 17, 2011

Physician Assistant (License #PA02832 in TX)

🟢

Initial NPI Registration & Enumeration August 07, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1497764260

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 07, 2006

Last Update: October 17, 2011

Sole Proprietor: No

Update or Correct Profile

Mailing Address

9125 Calvert Rd

Lantana, TX 762266452

Phone: 9729229561

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.