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NPI Code Detail

MEDICARE: MR. KEVIN LEE EDWARDS PHARMACIST

MEDICARE: MR. KEVIN LEE EDWARDS PHARMACIST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist30679TX

General Provider Information

NPI Number : 1346842127
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KEVIN LEE EDWARDS PHARMACIST
Provider Business Mailing Address
First Line : 607 E WALLISVILLE RD BLDG 1
Second Line :
City : HIGHLANDS
State : TX
Zip : 77562-3831
Country : US
Telephone Number : 832-838-8560
Fax Number : 832-838-8468
Provider Business Practice Location Address
First Line : 607 E WALLISVILLE RD BLDG 1
Second Line :
City : HIGHLANDS
State : TX
Zip : 77562-3831
Country : US
Telephone Number : 832-838-8560
Fax Number : 832-838-8468
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2020
Last Update Date : 11/16/2020

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