Provider Demographics
NPI:1144239997
Name:WOLSKI, EDWARD F (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:F
Last Name:WOLSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2436 S INTERSTATE 35 E
Mailing Address - Street 2:STE 336
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-4992
Mailing Address - Country:US
Mailing Address - Phone:940-484-7000
Mailing Address - Fax:940-484-7888
Practice Address - Street 1:2436 S INTERSTATE 35 E
Practice Address - Street 2:STE 336
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-4992
Practice Address - Country:US
Practice Address - Phone:940-484-7000
Practice Address - Fax:940-484-7888
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7964207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8S0280OtherBLUE CROSS BLUE SHIELD
TX89Z540Medicare ID - Type Unspecified
TX8S0280OtherBLUE CROSS BLUE SHIELD