Provider Demographics
NPI:1477508513
Name:QUIROS, EDWARD E (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:E
Last Name:QUIROS
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:PO BOX 5284
Mailing Address - Street 2:
Mailing Address - City:BORGER
Mailing Address - State:TX
Mailing Address - Zip Code:79008-5284
Mailing Address - Country:US
Mailing Address - Phone:806-273-7596
Mailing Address - Fax:806-274-3622
Practice Address - Street 1:600 W 3RD ST
Practice Address - Street 2:
Practice Address - City:BORGER
Practice Address - State:TX
Practice Address - Zip Code:79007-4008
Practice Address - Country:US
Practice Address - Phone:806-273-7596
Practice Address - Fax:806-274-3622
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE9342208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX879701OtherBLUE CROSS BLUE SHIELD
TXB25720Medicare UPIN
TX879701OtherBLUE CROSS BLUE SHIELD