Provider Demographics
NPI:1558897058
Name:EDIONWE, JOEL I (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:I
Last Name:EDIONWE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9150 HUEBNER RD STE 290
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1598
Mailing Address - Country:US
Mailing Address - Phone:210-614-6432
Mailing Address - Fax:210-293-2772
Practice Address - Street 1:18626 HARDY OAK BLVD STE 300
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4228
Practice Address - Country:US
Practice Address - Phone:210-614-6432
Practice Address - Fax:210-293-2772
Is Sole Proprietor?:No
Enumeration Date:2017-05-04
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXT432207X00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery