Provider Demographics
NPI:1366445645
Name:WADE, EDWARD C (M D)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:C
Last Name:WADE
Suffix:
Gender:M
Credentials:M D
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Mailing Address - Street 1:6565 WEST LOOP S
Mailing Address - Street 2:SUITE 650
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3500
Mailing Address - Country:US
Mailing Address - Phone:713-797-1010
Mailing Address - Fax:713-357-7276
Practice Address - Street 1:6565 WEST LOOP S
Practice Address - Street 2:SUITE 650
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3500
Practice Address - Country:US
Practice Address - Phone:713-797-1010
Practice Address - Fax:713-357-7276
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2019-07-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXG9692207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122661502Medicaid
TX122661505Medicaid
TX8F1216Medicare PIN
TX122661505Medicaid
TX00G15TMedicare PIN