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General NPI Number Information
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NPI Number | 1598035636
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Entity Type | Individual
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Provider Name | JON MICHAEL EDWARDS PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 01/06/2012
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Last Update Date | 01/06/2012
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Provider Practice Location Address
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Address Line | 4490 E 14TH ST
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City | BROWNSVILLE
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State | TX
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Zip | 78521-3240
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Country | US
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Telephone | 956-542-3891
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Fax |
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Provider Business Mailing Address
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Address Line | 1213 ELM RIDGE LN
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City | BROWNSVILLE
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State | TX
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Zip | 78520-9232
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Country | US
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Telephone | 956-466-8267
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 44509
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License Number State | TX
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