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General NPI Number Information
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NPI Number | 1346842127
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Entity Type | Individual
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Provider Name | KEVIN LEE EDWARDS PHARMACIST
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Gender | Male
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Dates
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Enumeration Date | 11/16/2020
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Last Update Date | 11/16/2020
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Provider Practice Location Address
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Address Line | 607 E WALLISVILLE RD BLDG 1
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City | HIGHLANDS
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State | TX
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Zip | 77562-3831
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Country | US
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Telephone | 832-838-8560
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Fax | 832-838-8468
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Provider Business Mailing Address
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Address Line | 607 E WALLISVILLE RD BLDG 1
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City | HIGHLANDS
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State | TX
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Zip | 77562-3831
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Country | US
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Telephone | 832-838-8560
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Fax | 832-838-8468
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 30679
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License Number State | TX
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