Eddie Demichael Waddle

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Practice address

16707 Sonata CT
Houston, TX 77053-5023

Phone

(832) 880-4629

NPI assigned

Jun 24, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1609437300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1243 MAGNOLIA DALE DR",
            "city": "FRESNO",
            "state": "TX",
            "postal_code": "775459681",
            "telephone_number": "832-880-4629",
            "fax_number": "281-972-9544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16707 SONATA CT",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770535023",
            "telephone_number": "832-880-4629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADDLE",
        "first_name": "EDDIE",
        "middle_name": "DEMICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-24",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01134881",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wad Management
• Jordon Jovan Waddel
• Caroline Cook Waddell
• Elizabeth Delcambre Waddell, AGACNP-BC
• Louis Clyde Waddell Jr., M.D.
• Tamika Waddle, PMHNP
• Kamili Wade-Reescano, LMFT
• Raquel D. Wade-Zeller, M.ED., LPC
• Akilah Wade, APRN, CPNP-PC
• Angela Wade

• Home Health Agency in Houston, TX
• Providers in Houston, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; 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.