Provider Demographics
NPI:1033539952
Name:CODD, ELIZA BETH (ARNP)
Entity Type:Individual
Prefix:MISS
First Name:ELIZA
Middle Name:BETH
Last Name:CODD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17350 ST LUKES WAY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4100
Mailing Address - Country:US
Mailing Address - Phone:281-444-3278
Mailing Address - Fax:
Practice Address - Street 1:17350 ST LUKES WAY
Practice Address - Street 2:SUITE 400
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-4100
Practice Address - Country:US
Practice Address - Phone:281-444-3278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-17
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX841559363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily