Provider Demographics
NPI:1356133680
Name:NOVA EDGE PHYSICIANS PLLC
Entity type:Organization
Organization Name:NOVA EDGE PHYSICIANS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WAFER
Authorized Official - Middle Name:S
Authorized Official - Last Name:GAMIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-664-0070
Mailing Address - Street 1:8668 JOHN HICKMAN PKWY STE 1001
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-9388
Mailing Address - Country:US
Mailing Address - Phone:469-664-0070
Mailing Address - Fax:469-217-3872
Practice Address - Street 1:8668 JOHN HICKMAN PKWY STE 1001
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-9388
Practice Address - Country:US
Practice Address - Phone:469-664-0070
Practice Address - Fax:469-217-3872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty