Provider Demographics
NPI:1508113846
Name:EDGE, DARSHE (MD)
Entity Type:Individual
Prefix:
First Name:DARSHE
Middle Name:
Last Name:EDGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6431 FANNIN ST
Mailing Address - Street 2:MSB G550A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-500-5874
Mailing Address - Fax:713-500-0590
Practice Address - Street 1:920 MEDICAL PLAZA DR STE 340
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3256
Practice Address - Country:US
Practice Address - Phone:713-897-4909
Practice Address - Fax:713-897-4919
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR2324208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX374441901Medicaid
TX591711YKY3OtherMEDICARE
TX8HE837OtherBCBS