Organization Active NPI

Patrick J Edwards MD PA

  • Family Medicine Physician
  • Tahoka, TX
National Provider Identifier
1295970952
Registry record updated Jul 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
207Q00000X Issued in TX
Legal business name
PATRICK J EDWARDS MD PA
Practice address
2600 Lockwood
Suite C
Tahoka, TX 79373
Phone
(806) 998-5501
Fax
(806) 561-5504
NPI assigned
Dec 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2009

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

Authorized official

Name
Dr. Patrick James Edwards, M.D.
Title
President
Phone
(806) 998-5501

Specialties & licenses 1

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

Addresses

Primary practice location

2600 Lockwood
Suite C
Tahoka, TX 79373

Mailing address

PO Box 1480
2600 Lockwood Suite C
Tahoka, TX 79373-1480
Phone (806) 998-5501

Other identifiers 3

IdentifierTypeStateIssuer
201884802OtherTEXAS MEDICAID TEXAS HEALTH STEPS
135749312MedicaidTX
201884801MedicaidTX

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1228867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247443200000",
    "number": "1295970952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1480",
            "address_2": "2600 LOCKWOOD SUITE C",
            "city": "TAHOKA",
            "state": "TX",
            "postal_code": "793731480",
            "telephone_number": "806-998-5501",
            "fax_number": "806-561-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 LOCKWOOD",
            "address_2": "SUITE C",
            "city": "TAHOKA",
            "state": "TX",
            "postal_code": "79373",
            "telephone_number": "806-998-5501",
            "fax_number": "806-561-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK J EDWARDS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-10",
        "last_updated": "2009-07-13",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "806-998-5501",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "207Q00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAID TEXAS HEALTH STEPS",
            "identifier": "201884802",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135749312",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201884801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahoka, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2009; 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.