Provider Demographics
NPI:1689867913
Name:TARYN TURNER D.O., P.A.
Entity Type:Organization
Organization Name:TARYN TURNER D.O., P.A.
Other - Org Name:EAGLE PASS KIDNEY CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TARYN
Authorized Official - Middle Name:JANETTE
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:830-968-8798
Mailing Address - Street 1:1739 RIO DRIVE
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852
Mailing Address - Country:US
Mailing Address - Phone:830-773-8878
Mailing Address - Fax:830-773-8891
Practice Address - Street 1:3147 MEGAN STREET
Practice Address - Street 2:SUITE 5
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-5885
Practice Address - Country:US
Practice Address - Phone:830-773-8878
Practice Address - Fax:830-773-8891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5025207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Y035Medicare PIN