Provider Demographics
NPI:1023668084
Name:EDWARDS, BRUSHIE ARNELL (MSN PHYSICAL THERAPY)
Entity type:Individual
Prefix:
First Name:BRUSHIE
Middle Name:ARNELL
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:MSN PHYSICAL THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 RENAULT WAY
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-6331
Mailing Address - Country:US
Mailing Address - Phone:318-332-7510
Mailing Address - Fax:
Practice Address - Street 1:701 RENAULT WAY
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-6331
Practice Address - Country:US
Practice Address - Phone:318-332-7510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-12
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1261077208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty