Provider Demographics
NPI:1417231069
Name:EICHLER, EDNA (NP)
Entity Type:Individual
Prefix:
First Name:EDNA
Middle Name:
Last Name:EICHLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2186 COUNTY ROAD 113
Mailing Address - Street 2:
Mailing Address - City:GIDDINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78942-1163
Mailing Address - Country:US
Mailing Address - Phone:512-984-7425
Mailing Address - Fax:512-984-5129
Practice Address - Street 1:6801 RIVER PLACE BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78726-4530
Practice Address - Country:US
Practice Address - Phone:512-984-7425
Practice Address - Fax:512-984-5129
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX609660363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health