EDGE-MD ILLINOIS, PLLC (NPI# 1285034728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285034728 |
| Entity Type | Organization |
| Organization Name | EDGE-MD ILLINOIS, PLLC |
| Practice Address |
2304 W Illinois Ave Dallas TX 75224-1638 |
| Mailing Address |
2022 Regional Medical Dr Suite 1315 Wharton TX 77488-7231 |
| Practice Telephone | 2143377200 |
| Practice Fax Number | 2143377206 |
| Mailing Telephone | 9795322000 |
| Mailing Fax Number | 9795322008 |
| Enumeration Date | 2014-09-03 |
| Last Update Date | 2015-01-13 |
| Authorized Official Name | DR. NATHAN P. NGUYEN (OWNER/MD) |
| Authorized Official Telephone | 9795322000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | N0318 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
2304 W ILLINOIS AVE |
| City | DALLAS |
| State | TX |
| Zip Code | 75224-1638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639449358 | Access Dental of Illinois Pa | Dentist | 2304 W Illinois Ave, Dallas, TX 75224 | 2012-01-11 |
| 1467921346 | Open Arms Healthcare of Texas Inc. | Family Medicine | 2304 W Illinois Ave, Dallas, TX 75224-1638 | 2018-11-20 |
| 1740540087 | Access Orthodontics of Illinois Pa | Dentist | 2304 W Illinois Ave, Dallas, TX 75224-1638 | 2012-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972133999 | Bra'sheika Renee Johnson | Pharmacist | 752 Wynnewood Village S/c, Dallas, TX 75224 | 2020-01-17 |
| 1821523317 | Hao Anh Dang | Dentist | 2221 W Ledbetter Dr Ste 100, Dallas, TX 75224 | 2017-04-22 |
| 1568820009 | Ashley Nicole Green | Dentist | 2221 W. Ledbetter Drive, Suite 100, Dallas, TX 75224 | 2016-01-28 |
| 1194138867 | Laurie Smith | Licensed Vocational Nurse | 3622 S Tyler St, Dallas, TX 75224 | 2014-06-10 |
| 1346667474 | Sherry Diann Flewellen-ervin | Counselor | 501 Wynnwood Village, Dallas, TX 75224 | 2014-03-26 |
| 1326381880 | Mercy Housecall Physicians Group, LLC | Clinic/Center | 501 Wynnrwood Village, Ste 102a, Dallas, TX 75224 | 2013-04-03 |
| 1437416971 | Masako Nishio M.d., P.a. | Anesthesiology | 2929 South Hampton Rd, Dallas, TX 75224 | 2012-04-23 |
| 1306119177 | Truevision Eye Care P.a. | Optometrist | 911 Wynnewood Village, Dallas, TX 75224 | 2012-02-09 |
| 1659649317 | Shambresha Lanette Sewell | Assisted Living Facility | 3911 Morning Spring Trl, Dallas, TX 75224 | 2011-12-09 |
| 1346527983 | Familia Care Inc. | Pharmacy | 655 W. Illinois Avenue, Building 900, Suite 916/918, Dallas, TX 75224 | 2011-11-10 |
| Find all providers in zip 75224 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245853811 | Forest Family Clinic, LLC | Family Medicine | 9550 Forest Ln Suite 606, Dallas, TX 75243-5905 | 2020-05-18 |
| 1104447937 | Centenary Family & Urgent Care | Family Medicine | 8702 S Lancaster Rd Ste 160a, Dallas, TX 75241-6301 | 2020-05-04 |
| 1285274456 | Genesis Health Partners Pllc | Family Medicine | 8390 Lbj Fwy Ste 1000b, Dallas, TX 75243-1188 | 2020-01-15 |
| 1194368266 | Sierra Healthcare Network LLC | Family Medicine | 2727 Lbj Fwy Ste 326, Dallas, TX 75234-7478 | 2019-10-22 |
| 1184274896 | Matilda N Nju | Family Medicine | 41 Kelso Way, Dallas, GA 30132-2618 | 2019-09-14 |
| 1992366488 | Anmd Health Pllc | Family Medicine | 1910 Pacific Ave Suite 15700, Dallas, TX 75201 | 2019-06-25 |
| 1366908600 | Advanced Wound Care of North Texas Pllc | Family Medicine | 13154 Coit Rd Ste 102d, Dallas, TX 75240-5787 | 2019-02-12 |
| 1932664935 | Environmental Health Center - North Texas Pa | Family Medicine | 8345 Walnut Hill Ln Ste 220, Dallas, TX 75231-4205 | 2019-02-04 |
| 1679043723 | Inwood Medical Clinic Inc. | Family Medicine | 2916 Inwood Rd, Dallas, TX 75235-7518 | 2018-12-03 |
| 1134698939 | Cayla Schaner | Family Medicine | 3600 Gaston Ave Ste 1109, Dallas, TX 75246-1811 | 2018-11-21 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.