Provider Demographics
NPI:1093021206
Name:EDWARDS, ANYA NIKKI
Entity Type:Individual
Prefix:MRS
First Name:ANYA
Middle Name:NIKKI
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 OAKDALE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-7728
Mailing Address - Country:US
Mailing Address - Phone:832-215-2631
Mailing Address - Fax:713-721-1828
Practice Address - Street 1:2616 OAKDALE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-7728
Practice Address - Country:US
Practice Address - Phone:832-215-2631
Practice Address - Fax:713-721-1828
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)