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General NPI Number Information
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NPI Number | 1235639022
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Entity Type | Individual
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Provider Name | PAULINE MARIE EDWARDS LVN
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Gender | Female
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Dates
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Enumeration Date | 02/19/2018
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Last Update Date | 02/19/2018
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Provider Practice Location Address
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Address Line | 7610 TYLER CREEK LN
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City | HUMBLE
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State | TX
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Zip | 77396-6064
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Country | US
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Telephone | 713-823-6507
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Fax |
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Provider Business Mailing Address
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Address Line | 12371 S KIRKWOOD RD
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City | STAFFORD
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State | TX
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Zip | 77477-2836
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Country | US
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Telephone | 713-995-9292
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Fax | 713-995-4402
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 121287
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License Number State | TX
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