Healthcare Provider Details

I. General information

NPI: 1811294382
Provider Name (Legal Business Name): ERIC DEUSCHLE RSA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2011
Last Update Date: 10/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7324 SOUTHWEST FREEWAY SUITE 1550
HOUSTON TX
77074-2053
US

IV. Provider business mailing address

7324 SOUTHWEST FREEWAY4 SUITE 1550
HOUSTON TX
77074-2053
US

V. Phone/Fax

Practice location:
  • Phone: 713-779-9800
  • Fax: 713-779-9813
Mailing address:
  • Phone: 713-779-9800
  • Fax: 713-779-9813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number238.000294
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number238.000294
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number238.000294
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number238.000294
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: