Phillip W Edmonds Jr., CSA

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

138187 Issued in TX

Practice address

9955 Kempwood Dr
Apt 804
Houston, TX 77080-2668

Phone

(832) 723-7692

NPI assigned

Feb 6, 2013

Last updated

Feb 6, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1360108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360108800000",
    "number": "1265771570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9955 KEMPWOOD DR",
            "address_2": "APT 804",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770802668",
            "telephone_number": "832-723-7692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9955 KEMPWOOD DR",
            "address_2": "APT 804",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770802668",
            "telephone_number": "832-723-7692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDS",
        "first_name": "PHILLIP",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CSA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-06",
        "last_updated": "2013-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "138187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimily Edmond, BS
• Tayler Edmond
• Jimmie E. Edmonds, LSA, OPAC
• Joseph Lindsay Edmonds Jr., MD
• Mieasha Edmonds, MA, MDIV,LPC
• Corbin Paul Edmondson, M.D.
• Ethan Alexander Edmondson, MD, MPH
• Everton Anthony Edmondson, M.D.
• Stella Borrego Edmondson, LCSW
• Sarah R. Edmonson, M.D.

• Surgical Assistant in Houston, TX
• Providers in Houston, TX by specialty
• Surgical Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.