MEDICARE: JUANITA P EDWARDS MD & ASSOC PA

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	208VP0014X	Interventional Pain Medicine Physician	M7161	TX
2	207LP2900X	Pain Medicine (Anesthesiology) Physician
3	208VP0000X	Pain Medicine Physician

General Provider Information

NPI Number	:	1598215105
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUANITA P EDWARDS MD & ASSOC PA

Provider Business Mailing Address
First Line	:	7508 CYPRESS CREEK PKWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-5806
Country	:	US
Telephone Number	:	281-788-2944
Fax Number	:	281-817-6699

Provider Business Practice Location Address
First Line	:	7508 CYPRESS CREEK PKWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-5806
Country	:	US
Telephone Number	:	281-788-2944
Fax Number	:	281-817-6699

Authorized Official
Title or Position	:	OWNER
Name	:	JUANITA P EDWARDS
Credential	:	M.D.
Telephone Number	:	281-788-2944

Provider Enumeration Date	:	10/06/2016
Last Update Date	:	01/27/2023

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