STEVEN RAY EDMONDSON MD NPI 1164429890

NPI Information

NPI: 1164429890
Provider Name: STEVEN RAY EDMONDSON, MD
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
3025 N TARRANT PKWY
SUITE 240
FORT WORTH, TX
ZIP 76177
Phone: (817) 431-1500
Get Directions

Steven Ray Edmondson, MD is an obstetrics gynecology in Fort Worth, TX. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. Steven Ray Edmondson, MD NPI is 1164429890. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3025 N TARRANT PKWY
SUITE 240
FORT WORTH, TX
ZIP 76177-620
Phone: (817) 431-1500

The NPI 1164429890 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/7/2005 and was last updated on 10/15/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207VG0400X	Obstetrics & Gynecology	Gynecology	G8830	TEXAS	No
2	207VX0000X	Obstetrics & Gynecology	Obstetrics	G8830	TEXAS	No
3	207V00000X	Obstetrics & Gynecology		G8830	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	C15418	MEDICARE UPIN	TEXAS
2	131769502	MEDICAID	TEXAS
3	131769508	MEDICAID	TEXAS
4	83022Y	OTHER	TEXAS	BLUE CROSS BLUE SHIELD
5	131769509	MEDICAID	TEXAS
6	131769510	MEDICAID	TEXAS
7	109380901	MEDICAID	TEXAS
8	0737147	OTHER	TEXAS	UNITED HEALTHCARE
9	2357545	OTHER	TEXAS	AETNA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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