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General NPI Number Information
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NPI Number | 1124055090
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Entity Type | Individual
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Provider Name | DAVID L EDELL LAT, ATC, CSCS
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Gender | Male
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1625 STAFFORDSHIRE RD
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City | STAFFORD
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State | TX
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Zip | 77477-6326
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Country | US
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Telephone | 281-261-9200
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Fax | 281-208-6117
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Provider Business Mailing Address
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Address Line | 2727 CHERYL CT
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City | MISSOURI CITY
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State | TX
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Zip | 77459-2930
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Country | US
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Telephone | 281-261-6031
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT1032
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License Number State | TX
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