Provider Demographics
NPI:1538465679
Name:AMERICAN EAGLE PHYSICIAN HOUSE CALL INC
Entity Type:Organization
Organization Name:AMERICAN EAGLE PHYSICIAN HOUSE CALL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:EBERECHI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:469-544-3556
Mailing Address - Street 1:6515 BRIAR LAKE TRL
Mailing Address - Street 2:
Mailing Address - City:SACHSE
Mailing Address - State:TX
Mailing Address - Zip Code:75048-5526
Mailing Address - Country:US
Mailing Address - Phone:469-544-3556
Mailing Address - Fax:972-442-3391
Practice Address - Street 1:6515 BRIAR LAKE TRL
Practice Address - Street 2:
Practice Address - City:SACHSE
Practice Address - State:TX
Practice Address - Zip Code:75048-5526
Practice Address - Country:US
Practice Address - Phone:496-544-3556
Practice Address - Fax:972-442-3391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-08
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty