Provider Demographics
NPI:1487443941
Name:ST-JUSTE, EDWINE
Entity type:Individual
Prefix:
First Name:EDWINE
Middle Name:
Last Name:ST-JUSTE
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 1:22407 CORAL CHASE CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-8211
Mailing Address - Country:US
Mailing Address - Phone:929-302-8199
Mailing Address - Fax:
Practice Address - Street 1:22407 CORAL CHASE CT
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-8211
Practice Address - Country:US
Practice Address - Phone:929-302-8199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-25-8702-928341247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other