Provider Demographics
NPI:1801368600
Name:HEDRICK, EDNA REBECCA
Entity Type:Individual
Prefix:
First Name:EDNA
Middle Name:REBECCA
Last Name:HEDRICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EDNA
Other - Middle Name:REBECCA
Other - Last Name:CRESCINI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:12022 GARNER MILL LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-2390
Mailing Address - Country:US
Mailing Address - Phone:832-317-7852
Mailing Address - Fax:713-609-9144
Practice Address - Street 1:8405 ALMEDA GENOA RD STE U
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77075-2569
Practice Address - Country:US
Practice Address - Phone:832-317-7852
Practice Address - Fax:713-609-9144
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-19
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139721363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily