Provider Demographics
NPI:1538351390
Name:MCDAVID, EDITH
Entity type:Individual
Prefix:
First Name:EDITH
Middle Name:
Last Name:MCDAVID
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 1:2200 BUSINESS CENTER DR
Mailing Address - Street 2:APT 2303
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1359
Mailing Address - Country:US
Mailing Address - Phone:713-838-5040
Mailing Address - Fax:
Practice Address - Street 1:2200 BUSINESS CENTER DR
Practice Address - Street 2:APT 2303
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-1359
Practice Address - Country:US
Practice Address - Phone:713-838-5040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103023235Z00000X
MSS2864235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist