Provider Demographics
NPI:1326007451
Name:BIEDERMANN, SCOTT A (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:A
Last Name:BIEDERMANN
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 1:4708 ALLIANCE BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5368
Mailing Address - Country:US
Mailing Address - Phone:469-467-0011
Mailing Address - Fax:469-467-4923
Practice Address - Street 1:4708 ALLIANCE BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5368
Practice Address - Country:US
Practice Address - Phone:469-467-0011
Practice Address - Fax:469-467-4923
Is Sole Proprietor?:No
Enumeration Date:2006-03-18
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3581207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7253672OtherAETNA
TX165409709Medicaid
TX207733OtherPACIFICARE
TX165409710Medicaid