Provider Demographics
NPI:1851655252
Name:EDWARDS, EMILY LOUISE (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:LOUISE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:LOUISE
Other - Last Name:MACKIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8506 DALEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-7513
Mailing Address - Country:US
Mailing Address - Phone:210-410-2025
Mailing Address - Fax:
Practice Address - Street 1:499 10TH ST
Practice Address - Street 2:
Practice Address - City:FLORESVILLE
Practice Address - State:TX
Practice Address - Zip Code:78114-3175
Practice Address - Country:US
Practice Address - Phone:830-393-1340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR5006207P00000X
SCLL34838207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine