Individual
ERNEST WAYNE EDMONDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1800 7TH ST, WICHITA FALLS, TX 76301-4204
(940) 723-2373
(940) 723-1890
Mailing address
4495 HWY 79 S., WICHITA FALLS, TX 76310-0535
(940) 691-4360
(940) 723-1890
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00973
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TX 00973
TEXAS LICENSE/PERMIT
TX
Enumeration date
08/07/2006
Last updated
07/08/2007
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