Provider Demographics
NPI:1467567826
Name:WEBB, EDDIE B
Entity Type:Individual
Prefix:
First Name:EDDIE
Middle Name:B
Last Name:WEBB
Suffix:
Gender:M
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 91351
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77291-1351
Mailing Address - Country:US
Mailing Address - Phone:713-884-1610
Mailing Address - Fax:713-884-1611
Practice Address - Street 1:1343 RAINY RIVER DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77088-3522
Practice Address - Country:US
Practice Address - Phone:713-884-1610
Practice Address - Fax:713-884-1611
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1013033416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAMB283Medicare PIN