Provider Demographics
NPI:1326005893
Name:BORCHARD, EDWARD LEE (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:LEE
Last Name:BORCHARD
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 1:6434 SARATOGA BLVD
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-3425
Mailing Address - Country:US
Mailing Address - Phone:361-991-1885
Mailing Address - Fax:361-991-1839
Practice Address - Street 1:6434 SARATOGA BLVD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-3425
Practice Address - Country:US
Practice Address - Phone:361-991-1885
Practice Address - Fax:361-991-1839
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5826208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG81105Medicare UPIN