Individual
EDWARD FRANCIS ENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
700 SMITH ST #61070, SMB #19681, HOUSTON, TX 77002
(817) 438-6474
Mailing address
5837 FAIRCREST CV APT 812, FORT WORTH, TX 76137-6822
(817) 438-6474
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
T3767
TX
207Q00000X
Family Medicine Physician
T3767
TX
208D00000X
General Practice Physician
Primary
T3767
TX
Other
Enumeration date
04/16/2018
Last updated
01/03/2022
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