Provider Demographics
NPI:1275593105
Name:ECKBURG, EVA M (PT, MS)
Entity Type:Individual
Prefix:MRS
First Name:EVA
Middle Name:M
Last Name:ECKBURG
Suffix:
Gender:F
Credentials:PT, MS
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Mailing Address - Street 1:4206 ALOVETTE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4313
Mailing Address - Country:US
Mailing Address - Phone:210-256-6610
Mailing Address - Fax:210-292-7991
Practice Address - Street 1:2200 BERGQUIST DRIVE, SUITE 1
Practice Address - Street 2:ATTN: CREDENTIALS (CMC)
Practice Address - City:LACKLAND AFB
Practice Address - State:TX
Practice Address - Zip Code:78236-5300
Practice Address - Country:US
Practice Address - Phone:210-292-6707
Practice Address - Fax:210-292-7964
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA625225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist