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General NPI Number Information
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NPI Number | 1922113489
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Entity Type | Individual
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Provider Name | BETTY ACKER
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Gender | Female
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 11/10/2015
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Provider Practice Location Address
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Address Line | 2900 E 29TH ST STE 300
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City | BRYAN
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State | TX
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Zip | 77802-2603
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Country | US
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Telephone | 979-776-5602
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Fax | 979-776-5265
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Provider Business Mailing Address
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Address Line | PO BOX 70368
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City | SPRINGFIELD
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State | OR
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Zip | 97475-0120
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Country | US
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Telephone | 541-868-9719
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Fax | 541-246-2353
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD174681
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License Number State | OR
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