Provider Demographics
NPI:1912941295
Name:EDWARD A GEORGE MD PA
Entity Type:Organization
Organization Name:EDWARD A GEORGE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-484-9980
Mailing Address - Street 1:11914 ASTORIA BLVD
Mailing Address - Street 2:SUITE 280
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-6064
Mailing Address - Country:US
Mailing Address - Phone:281-484-9980
Mailing Address - Fax:281-484-5869
Practice Address - Street 1:11914 ASTORIA BLVD
Practice Address - Street 2:SUITE 280
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-6064
Practice Address - Country:US
Practice Address - Phone:281-484-9980
Practice Address - Fax:281-484-5869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE1589207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00AA20Medicare ID - Type Unspecified
C16041Medicare UPIN