MEDICARE: DR. ANETTE TEMPLE EDENS PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	25242	TX

General Provider Information

NPI Number	:	1124183942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANETTE TEMPLE EDENS PHD

Provider Business Mailing Address
First Line	:	1040 LOUISE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77009-2956
Country	:	US
Telephone Number	:	713-252-2290
Fax Number	:

Provider Business Practice Location Address
First Line	:	1040 LOUISE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77009-2956
Country	:	US
Telephone Number	:	713-252-2290
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2006
Last Update Date	:	01/24/2017

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