Healthcare Provider Details

I. General information

NPI: 1417231069
Provider Name (Legal Business Name): EDNA EICHLER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2011
Last Update Date: 09/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 RIVER PLACE BLVD
AUSTIN TX
78726-4530
US

IV. Provider business mailing address

2186 COUNTY ROAD 113
GIDDINGS TX
78942-1163
US

V. Phone/Fax

Practice location:
  • Phone: 512-984-7425
  • Fax: 512-984-5129
Mailing address:
  • Phone: 512-984-7425
  • Fax: 512-984-5129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number609660
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: