Individual provider Active NPI

Lillian Moreno-Edmonds, PA-C

  • Medical Physician Assistant
  • The Woodlands, TX
National Provider Identifier
1619523644
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA13148 Issued in TX
Practice address
17600 Interstate 45 S
The Woodlands, TX 77384-5148
Phone
(936) 267-5000
NPI assigned
Aug 15, 2019
Last updated
Apr 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA13148 TX Primary

Addresses

Primary practice location

17600 Interstate 45 S
The Woodlands, TX 77384-5148

Mailing address

17600 Interstate 45 S
The Woodlands, TX 77384-5148

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200414001559 TX Practitioner - Physician Assistant 4385074442 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA13148TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sherman Apothecary, LP PastSince Feb 16, 2020 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1619523644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17600 INTERSTATE 45 S",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773845148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17600 INTERSTATE 45 S",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773845148",
            "telephone_number": "936-267-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO-EDMONDS",
        "first_name": "LILLIAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-15",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA13148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

Verify at the official NPI Registry.