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General NPI Number Information
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NPI Number | 1902670037
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Entity Type | Individual
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Provider Name | EDRICKA GREENE RDMS
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Gender | Female
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Dates
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Enumeration Date | 11/09/2023
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Last Update Date | 11/09/2023
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Provider Practice Location Address
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Address Line | 21650 ALDINE WESTFIELD RD
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City | HUMBLE
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State | TX
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Zip | 77338-1092
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Country | US
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Telephone | 713-853-9139
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Fax | 832-626-9756
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Provider Business Mailing Address
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Address Line | 2162 SPRING STUEBNER RD STE 140 BOX 497
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City | SPRING
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State | TX
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Zip | 77389-5299
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Country | US
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Telephone | 713-853-9139
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Fax | 832-626-9756
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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 | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | 197767
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License Number State | TX
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