Provider Demographics
NPI:1861715997
Name:EDWARDS, ANGELINA R (MD)
Entity type:Individual
Prefix:
First Name:ANGELINA
Middle Name:R
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST STE 1001
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2740
Mailing Address - Country:US
Mailing Address - Phone:713-363-8592
Mailing Address - Fax:713-790-3013
Practice Address - Street 1:6550 FANNIN ST STE 1001
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2740
Practice Address - Country:US
Practice Address - Phone:713-363-8592
Practice Address - Fax:713-790-3013
Is Sole Proprietor?:No
Enumeration Date:2010-03-03
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5029207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX213862004Medicaid
TX213862004Medicaid