Edmondson, Everton Anthony
Edmondson, Everton Anthony is an individual health care provider with primary practice located at 6560 Fannin St Suite 1234, Houston TX 77030-2761. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Pain Medicine, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Edmondson, Everton Anthony can be contacted via phone (713) 797-1180.Contact Information
Primary practice address
6560 Fannin St Suite 1234
Houston TX 77030-2761
Phone: (713) 797-1180
Fax: (713) 797-0641
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | G9451 | Texas |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | G9451 | Texas |
Profile Details
| NPI number | 1912985813 |
|---|---|
| LBN Legal business name | Edmondson, Everton Anthony |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 3rd, 2006 |
| Last updated | Nov 13th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912985813 | NPPES |
| Texas | MEDICAID | 139241712 | |
| Texas | MEDICAID | 139241716 | |
| Texas | MEDICAID | 139241717 | |
| Texas | Other | 8AJ445 |
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