Provider Demographics
NPI:1316999063
Name:EDNA M. LEWIN
Entity type:Organization
Organization Name:EDNA M. LEWIN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:LEWIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:281-575-0526
Mailing Address - Street 1:7215 LA GRANADA DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-4136
Mailing Address - Country:US
Mailing Address - Phone:281-575-0526
Mailing Address - Fax:281-575-0057
Practice Address - Street 1:7215 LA GRANADA DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-4136
Practice Address - Country:US
Practice Address - Phone:281-575-0526
Practice Address - Fax:281-575-0057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX025079701Medicaid
TX1799454Medicaid
678286Medicare ID - Type Unspecified