Provider Demographics
NPI:1669757340
Name:EDWARDS, PINKIE LASHELL (PRN)
Entity type:Individual
Prefix:MRS
First Name:PINKIE
Middle Name:LASHELL
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:PRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9728 LONGHILL DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-5416
Mailing Address - Country:US
Mailing Address - Phone:662-425-9027
Mailing Address - Fax:
Practice Address - Street 1:6020 W PARKER RD
Practice Address - Street 2:STE. 200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8171
Practice Address - Country:US
Practice Address - Phone:972-608-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1204470225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist