Provider Demographics
NPI:1326392051
Name:EDWARDS, CATHERINE ANNE (PA-C)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANNE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1219
Mailing Address - Street 2:
Mailing Address - City:BURNET
Mailing Address - State:TX
Mailing Address - Zip Code:78611-7219
Mailing Address - Country:US
Mailing Address - Phone:830-693-2600
Mailing Address - Fax:830-693-9755
Practice Address - Street 1:1800 MORMON MILL RD STE B
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654
Practice Address - Country:US
Practice Address - Phone:830-693-2600
Practice Address - Fax:830-693-9755
Is Sole Proprietor?:No
Enumeration Date:2012-11-02
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA09854363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant