Individual
EDITH IDEHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4502 RIVERSTONE BLVD STE 905, MISSOURI CITY, TX 77459-5206
(281) 903-7613
Mailing address
20314 JADE PARK DR, RICHMOND, TX 77407-4173
(713) 517-3897
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
767036
NY
Other
Enumeration date
08/31/2018
Last updated
08/31/2018
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