Organization Active NPI

Edge-MD Holding PLLC

Doing business as Medico MD

  • Family Medicine Physician
  • Irving, TX
National Provider Identifier
1285086397
Registry record updated Jan 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EDGE-MD HOLDING PLLC
Doing business as
Medico MD
Practice address
1200 W. Walnut Hill Lane
Suite 3950
Irving, TX 75038
Phone
(972) 514-1672
Fax
(214) 699-4397
NPI assigned
Jul 13, 2016
Last updated
Jan 8, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Nathan Phuckhac NguyenNPI 1821256942
Title
Owner
Phone
(979) 532-2000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1200 W. Walnut Hill Lane
Suite 3950
Irving, TX 75038

Mailing address

1200 W. Walnut Hill Lane
Suite 3950
Irving, TX 75038
Phone (972) 514-1672

Other names 1

  • Medico MD Doing business as

National Provider Directory

National Provider Directory

Locations

2440 S Collins St
Ste 140
Arlington, TX 76014
Phone (817) 459-2501

6901 McCart Ave
Ste 175
Fort Worth, TX 76133
Phone (817) 263-8500

1200 W Walnut Hill Ln
Irving, TX 75038
Phone (972) 514-1672

1810 S WW White Rd
Ste 123
San Antonio, TX 78220

4315 Fredericksburg Rd
Ste 100A
San Antonio, TX 78201
Phone (210) 530-8841

7603 Culebra Rd
San Antonio, TX 78251
Phone (210) 680-0299

1329 S Valley Mills Dr
Waco, TX 76711
Phone (254) 221-1901

1437 S Valley Mills Dr
Waco, TX 76711
Phone (254) 221-1901

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515369600000",
    "number": "1285086397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W. WALNUT HILL LANE",
            "address_2": "SUITE 3950",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "75038",
            "telephone_number": "972-514-1672",
            "fax_number": "214-699-4397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W. WALNUT HILL LANE",
            "address_2": "SUITE 3950",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "75038",
            "telephone_number": "972-514-1672",
            "fax_number": "214-699-4397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGE-MD HOLDING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-13",
        "last_updated": "2018-01-08",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "PHUCKHAC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "979-532-2000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medico MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.