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General NPI Number Information
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NPI Number | 1215507389
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Entity Type | Individual
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Provider Name | EDIDIONG I JAMES FNP
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Gender | Female
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Dates
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Enumeration Date | 06/30/2021
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 21630 MERCHANTS WAY
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City | KATY
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State | TX
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Zip | 77449-2514
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Country | US
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Telephone | 832-230-1518
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Fax |
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Provider Business Mailing Address
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Address Line | 7424 FM 359 RD
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City | RICHMOND
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State | TX
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Zip | 77406-7723
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1158238
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 933628
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License Number State | TX
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