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NPI Code Detail

MEDICARE: DR. JAMES P VAN EYK D.D.S.

MEDICARE: DR. JAMES P VAN EYK D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryTX

General Provider Information

NPI Number : 1215152376
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES P VAN EYK D.D.S.
Provider Business Mailing Address
First Line : 6104 S 1ST ST STE 103
Second Line :
City : AUSTIN
State : TX
Zip : 78745-4052
Country : US
Telephone Number : 512-443-6680
Fax Number : 512-443-6680
Provider Business Practice Location Address
First Line : 6104 S 1ST ST STE 103
Second Line :
City : AUSTIN
State : TX
Zip : 78745-4052
Country : US
Telephone Number : 512-443-6680
Fax Number : 512-443-6680
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2007
Last Update Date : 07/08/2007

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