Provider Demographics
NPI:1366509119
Name:EDWARDS, RHONDA S (PA-C)
Entity Type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:S
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 1:1001 N WALDROP DR
Mailing Address - Street 2:STE 403
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-4705
Mailing Address - Country:US
Mailing Address - Phone:817-701-4253
Mailing Address - Fax:
Practice Address - Street 1:1001 N WALDROP DR
Practice Address - Street 2:STE 403
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-4705
Practice Address - Country:US
Practice Address - Phone:817-701-4253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04794363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant