Provider Demographics
NPI:1104165653
Name:EDWARDS, TELENA
Entity type:Individual
Prefix:
First Name:TELENA
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 S LOOP W
Mailing Address - Street 2:SUITE 100H
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2662
Mailing Address - Country:US
Mailing Address - Phone:713-398-1060
Mailing Address - Fax:
Practice Address - Street 1:2616 S LOOP W
Practice Address - Street 2:SUITE 100H
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2662
Practice Address - Country:US
Practice Address - Phone:713-398-1060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care