Provider Demographics
NPI:1912983206
Name:EDLING, JASON E (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:E
Last Name:EDLING
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 1:7521 WHITE CASTLE LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-3715
Mailing Address - Country:US
Mailing Address - Phone:972-523-8510
Mailing Address - Fax:719-888-1681
Practice Address - Street 1:7521 WHITE CASTLE LN
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-3715
Practice Address - Country:US
Practice Address - Phone:972-523-8510
Practice Address - Fax:719-888-1681
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-19
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.142221207RG0100X
TXH0324207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX117280103Medicaid
TX82W274OtherBCBS
TX82W274Medicare PIN
TX117280103Medicaid
TX82W274OtherBCBS