Provider Demographics
NPI:1154065266
Name:EDGAR MCELROY III DDS
Entity Type:Organization
Organization Name:EDGAR MCELROY III DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:
Authorized Official - Last Name:MCELROY
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-551-8861
Mailing Address - Street 1:1801 LISBURN DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-3351
Mailing Address - Country:US
Mailing Address - Phone:214-551-8861
Mailing Address - Fax:
Practice Address - Street 1:3094 LAURA LN STE 100
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-4569
Practice Address - Country:US
Practice Address - Phone:214-551-8861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies