Provider Demographics
NPI:1437400058
Name:PHYSICIANS EXPRESS PLLC
Entity Type:Organization
Organization Name:PHYSICIANS EXPRESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DELBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:EDWARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-993-1083
Mailing Address - Street 1:4929 BURNEY DR STE 120
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-2708
Mailing Address - Country:US
Mailing Address - Phone:361-993-1083
Mailing Address - Fax:361-356-1850
Practice Address - Street 1:4929 BURNEY DR STE 120
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-2708
Practice Address - Country:US
Practice Address - Phone:361-993-1083
Practice Address - Fax:361-356-1850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-21
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE2197207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty