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Individual

EDNA C IWUNDU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
12518 BERRY LAUREL LN, HOUSTON, TX 77014-2445
(832) 633-8139
(281) 440-6867
Mailing address
12518 BERRY LAUREL LN, HOUSTON, TX 77014-2445
(832) 633-8139
(281) 440-6867

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
374U00000X
Home Health Aide
Primary
376K00000X
Nurse's Aide

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
320493326
IRS
TX
Enumeration date
10/29/2012
Last updated
10/29/2012
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