=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023007432
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANE COVINGTON EDMOND M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/18/2005
-----------------------------------------------------
Last Update Date | 12/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6621 FANNIN ST MCCC 640.00
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77030-2303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-822-3230
-----------------------------------------------------
Fax | 832-825-4776
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 4771
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77210-4771
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-822-3230
-----------------------------------------------------
Fax | 713-796-8110
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number | H0326
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207WX0109X
-----------------------------------------------------
Taxonomy Name | Neuro-ophthalmology Physician
-----------------------------------------------------
License Number | H0326
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------