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General NPI Number Information
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NPI Number | 1912484932
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Entity Type | Individual
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Provider Name | DARA BREON EDWARDS NP
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Gender | Female
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Dates
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Enumeration Date | 07/23/2018
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Last Update Date | 11/15/2022
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Provider Practice Location Address
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Address Line | 8498 S SAM HOUSTON PKWY E STE 100
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City | HOUSTON
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State | TX
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Zip | 77075-4892
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Country | US
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Telephone | 832-937-5919
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Fax |
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Provider Business Mailing Address
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Address Line | 3702 AMOROSO DR
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City | IOWA COLONY
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State | TX
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Zip | 77583-1190
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Country | US
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Telephone | 832-865-2821
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 135137
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License Number State | TX
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