Healthcare Provider Details

I. General information

NPI: 1366435133
Provider Name (Legal Business Name): EDWARD PATRICK HOUSER FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 10/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 FRANCISCAN DR. ST. JOSEPH REGIONAL HEALTH CENTER
BRYAN TX
77802-2501
US

IV. Provider business mailing address

5410 MARYLAND WAY SUITE 300
BRENTWOOD TN
37027-5064
US

V. Phone/Fax

Practice location:
  • Phone: 979-776-5967
  • Fax: 979-774-4849
Mailing address:
  • Phone: 615-377-5652
  • Fax: 888-241-1404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number547658
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number547658
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: