Provider Demographics
NPI:1093966590
Name:EDRINGTON, ROXANNE
Entity Type:Individual
Prefix:DR
First Name:ROXANNE
Middle Name:
Last Name:EDRINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:ROXANNE
Other - Middle Name:
Other - Last Name:COCKRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1560 LIVE OAK ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4147
Mailing Address - Country:US
Mailing Address - Phone:281-554-8919
Mailing Address - Fax:281-554-6045
Practice Address - Street 1:1560 LIVE OAK ST
Practice Address - Street 2:SUITE A
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4147
Practice Address - Country:US
Practice Address - Phone:281-554-8919
Practice Address - Fax:281-554-6045
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6135111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition