Provider Demographics
NPI:1871629840
Name:EDWARDS, DONNA LOUELLA (PMH- NP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:LOUELLA
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:PMH- NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:9525 KATY FWY
Mailing Address - Street 2:SUITE 312
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1407
Mailing Address - Country:US
Mailing Address - Phone:713-463-9449
Mailing Address - Fax:713-463-7181
Practice Address - Street 1:9525 KATY FWY
Practice Address - Street 2:SUITE 312
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1407
Practice Address - Country:US
Practice Address - Phone:713-463-9449
Practice Address - Fax:713-463-7181
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX548607363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165447702Medicaid
TXP00235651OtherRAILROAD MEDICARE
TX611450Medicare PIN
TXP97609Medicare UPIN