| Organization Name: | MEDICAL EDGE HEALTHCARE GROUP PA |
| NPI Number: | 1063573541 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CLAY HEIGHTEN (PRESIDENT) |
| Mailing Address: | 1645 N Town East Blvd Ste 503 Mesquite |
| State: | TX US |
| Postal Code: | 751504147 |
| Phone Number: | 9726863901 |
| Fax Number: | 9726863985 |
| NPI Enumeration Date: | 12/12/2006 |
| NPI Last Update Date: | 09/09/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0206X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology, Mammography |
| Taxonomy Definition: | |