Individual
EDWARD A GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
507 N SAM HOUSTON PKWY E, SUITE 125, HOUSTON, TX 77060-4021
(832) 622-2386
(800) 434-4305
Mailing address
4018 MEADOWGOLD LN, SUITE 125, KINGWOOD, TX 77345-1008
(832) 622-2386
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
01647
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037320101
—
TX
01
—
80552W
BCBS TEXAS
TX
Enumeration date
08/11/2005
Last updated
07/07/2016
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