Provider Demographics
NPI:1881692531
Name:TSE, EDWARD K (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:K
Last Name:TSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:EDWARD
Other - Middle Name:KIN-CHOW
Other - Last Name:TSE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:9129 MESA DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77028-1606
Mailing Address - Country:US
Mailing Address - Phone:713-633-8450
Mailing Address - Fax:713-633-5079
Practice Address - Street 1:9129 MESA DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77028-1606
Practice Address - Country:US
Practice Address - Phone:713-633-8450
Practice Address - Fax:713-633-5079
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4413207R00000X, 208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B27108Medicare UPIN
00AQ86Medicare ID - Type Unspecified