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General NPI Number Information
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NPI Number | 1497764260
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Entity Type | Individual
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Provider Name | AMY LYNN EDWARDS PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 10/17/2011
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Provider Practice Location Address
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Address Line | 1405 W JEFFERSON ST
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City | WAXAHACHIE
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State | TX
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Zip | 75165-2231
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Country | US
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Telephone | 972-923-7178
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Fax |
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Provider Business Mailing Address
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Address Line | 9125 CALVERT RD
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City | LANTANA
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State | TX
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Zip | 76226-6452
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Country | US
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Telephone | 972-922-9561
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA02832
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License Number State | TX
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