Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0203X | Pediatric Critical Care Doctor | AP141171 | TX |
Y | 363LP0222X | Nurse Practitioner Pediatrics (Critical Care) | AP1411171 | TX |
NPI | 1255894846 |
---|---|
Provider Name | Tammy L Eckhardt |
First Address | Houston, TX 77021-2039 |
Second Address | Houston, TX 77030-2608 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2019 |
Last Update Date | 25/04/2019 |