Provider Demographics
NPI:1366435133
Name:HOUSER, EDWARD PATRICK (FNP)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:PATRICK
Last Name:HOUSER
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5410 MARYLAND WAY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5064
Mailing Address - Country:US
Mailing Address - Phone:615-377-5652
Mailing Address - Fax:888-241-1404
Practice Address - Street 1:2801 FRANCISCAN DR.
Practice Address - Street 2:ST. JOSEPH REGIONAL HEALTH CENTER
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2501
Practice Address - Country:US
Practice Address - Phone:979-776-5967
Practice Address - Fax:979-774-4849
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX547658207RC0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8Y9640OtherBCBS OF TEXAS
TX162814104Medicaid
P86469Medicare UPIN
TX8D8645Medicare PIN
TX8Y9640OtherBCBS OF TEXAS