NPIMap

Organization Active NPI

Edge-MD Holding PLLC

Doing business as Medico MD

  • Physiological Laboratory
  • Irving, TX
National Provider Identifier
1497222343
Registry record updated Oct 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
EDGE-MD HOLDING PLLC
Doing business as
Medico MD
Practice address
1200 W Walnut Hill LN Ste 1300
Irving, TX 75038-3050
Phone
(972) 514-1672
NPI assigned
Oct 30, 2018
Last updated
Oct 30, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2018

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

Authorized official

Name
Andrea Carrillo
Title
Manager
Phone
(512) 920-3107

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X Primary

Addresses

Primary practice location

1200 W Walnut Hill LN Ste 1300
Irving, TX 75038-3050

Mailing address

1200 W Walnut Hill LN Ste 1300
Irving, TX 75038-3050
Phone (972) 514-1672

Other names 1

  • Medico MD Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1540857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540857600000",
    "number": "1497222343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W WALNUT HILL LN STE 1300",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750383050",
            "telephone_number": "972-514-1672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W WALNUT HILL LN STE 1300",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750383050",
            "telephone_number": "972-514-1672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGE-MD HOLDING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-30",
        "last_updated": "2018-10-30",
        "status": "A",
        "authorized_official_last_name": "CARRILLO",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "512-920-3107"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "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 Oct 30, 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.