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DR. RUSSELL BENJAMIN EDWARDS DO NPI 1629305404


NPI Information

NPI: 1629305404
Provider Name: DR. RUSSELL BENJAMIN EDWARDS, DO
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
2451 S FM 51
#200
DECATUR, TX
ZIP 76234
Phone: (940) 627-2409
Get Directions

DR. Russell Benjamin Edwards, DO is an obstetrics gynecology in Decatur, TX with 18 years of experience. 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. DR. Russell Benjamin Edwards, DO NPI is 1629305404. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF NORTH TEXAS HSC, COLLEGE OF OSTEOPATHIC MED
Graduation Year:2006

The provider's business location address is:

2451 S FM 51
#200
DECATUR, TX
ZIP 76234-858
Phone: (940) 627-2409
Fax: (940) 626-4579

The NPI 1629305404 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 11/16/2009 and was last updated on 4/17/2019.


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
1207V00000XObstetrics & GynecologyN1312TEXASYes

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
18CN347OTHERTEXASBCBS
2284869901MEDICAIDTEXAS

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.