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Individual

JAMES WILLIE EDMOND JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7109 JOHN RALSTON RD, HOUSTON, TX 77044-2621
(832) 216-1007
Mailing address
PO BOX 96603, HOUSTON, TX 77213-6603
(832) 216-1007

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
81-2775843
TX
Enumeration date
01/12/2018
Last updated
01/12/2018
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