Provider Demographics
NPI:1336641208
Name:KAZMIR, EDWARD JOHN (FNP-C; PMHNP- BC)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:JOHN
Last Name:KAZMIR
Suffix:
Gender:M
Credentials:FNP-C; PMHNP- BC
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 511
Mailing Address - Street 2:
Mailing Address - City:HUNGERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77448-0511
Mailing Address - Country:US
Mailing Address - Phone:713-816-5646
Mailing Address - Fax:
Practice Address - Street 1:4706 AIRPORT AVE
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-5645
Practice Address - Country:US
Practice Address - Phone:281-239-1451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-06
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136841363LP2300X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty