Provider Demographics
NPI:1437677903
Name:DREW, EDWINA LAVERNE
Entity Type:Individual
Prefix:MISS
First Name:EDWINA
Middle Name:LAVERNE
Last Name:DREW
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:PO BOX 16842
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-6842
Mailing Address - Country:US
Mailing Address - Phone:713-701-9398
Mailing Address - Fax:888-483-2479
Practice Address - Street 1:2616 S LOOP W STE 301G
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2875
Practice Address - Country:US
Practice Address - Phone:713-701-9398
Practice Address - Fax:888-483-2479
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-06
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies