Provider Demographics
NPI:1245269604
Name:FREEMAN, EDWARD B (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:B
Last Name:FREEMAN
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 1:3901 E STAN SCHLUETER LOOP STE 202
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-4554
Mailing Address - Country:US
Mailing Address - Phone:254-634-4244
Mailing Address - Fax:254-634-8809
Practice Address - Street 1:3901 E STAN SCHLUETER LOOP STE 202
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-4554
Practice Address - Country:US
Practice Address - Phone:254-634-4244
Practice Address - Fax:254-634-8809
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ41272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX131194608Medicaid
TX8B9765Medicare PIN
TXF91042Medicare UPIN