Eichelberger Medical Practice, P.a.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

C6308 Issued in TX

Legal business name

EICHELBERGER MEDICAL PRACTICE, P.A.

Practice address

1610 James Bowie Drive
Suite A103
Baytown, TX 77520-3346

Phone

(281) 427-8502

Fax

(281) 420-5575

NPI assigned

Sep 9, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Philip Theodric Eichelberger Jr., M.D.

Title

President

Phone

(281) 427-8502

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283990400000",
    "number": "1073820254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 JAMES BOWIE DRIVE",
            "address_2": "SUITE A103",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775203346",
            "telephone_number": "281-427-8502",
            "fax_number": "281-420-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 JAMES BOWIE DRIVE",
            "address_2": "SUITE A103",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775203346",
            "telephone_number": "281-427-8502",
            "fax_number": "281-420-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EICHELBERGER MEDICAL PRACTICE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-09",
        "last_updated": "2010-09-09",
        "status": "A",
        "authorized_official_last_name": "EICHELBERGER",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "THEODRIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-427-8502",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "TX",
            "license": "C6308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122199604",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Baytown, TX
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.