Provider Demographics
NPI:1053850727
Name:EDQUILANG, MARIA VICTORIA (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:VICTORIA
Last Name:EDQUILANG
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2627 CREEK TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-2352
Mailing Address - Country:US
Mailing Address - Phone:832-232-1909
Mailing Address - Fax:
Practice Address - Street 1:1500 SUNSET DR
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-4724
Practice Address - Country:US
Practice Address - Phone:281-992-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-14
Last Update Date:2022-01-17
Deactivation Date:2021-12-17
Deactivation Code:
Reactivation Date:2022-01-17
Provider Licenses
StateLicense IDTaxonomies
TXAP133230363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81-5350678OtherTAX ID