Individual provider Active NPI

Eddie L Watson, PHD

  • Community Health Worker
  • Missouri City, TX
National Provider Identifier
1982048815
Registry record updated Apr 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
1435 Crescent Oak Dr
Missouri City, TX 77459-4564
Phone
(713) 370-5247
Fax
(713) 456-2744
NPI assigned
Apr 22, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X TX Primary

Addresses

Primary practice location

1435 Crescent Oak Dr
Missouri City, TX 77459-4564

Mailing address

1435 Crescent Oak Dr
Missouri City, TX 77459-4564
Phone (713) 370-5247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366588800000",
    "number": "1982048815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 CRESCENT OAK DR",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774594564",
            "telephone_number": "713-370-5247",
            "fax_number": "713-456-2744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 CRESCENT OAK DR",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774594564",
            "telephone_number": "713-370-5247",
            "fax_number": "713-456-2744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "EDDIE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-22",
        "last_updated": "2013-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missouri City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.