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General NPI Number Information
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NPI Number | 1376691865
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Entity Type | Individual
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Provider Name | TANYA YVONNE TICE-ESKOLA PHARMD
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Gender | Female
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 02/27/2015
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Provider Practice Location Address
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Address Line | 36000 DARNALL LOOP CARL R. DARNALL ARMY MEDICAL CENTER
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City | FORT HOOD
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State | TX
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Zip | 76544
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Country | US
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Telephone | 254-288-8824
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Fax | 254-288-8960
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Provider Business Mailing Address
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Address Line | 853 COUNTY ROAD 209
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City | LAMPASAS
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State | TX
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Zip | 76550-3768
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Country | US
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Telephone | 512-525-3062
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 29110
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License Number State | TX
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