1992000269 NPI number — MRS. TAMARA DAWN ESKUE P.A.

Table of content: DR. NHIEN DOAN DDS (NPI 1689855439)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992000269 NPI number — MRS. TAMARA DAWN ESKUE P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ESKUE
Provider First Name:
TAMARA
Provider Middle Name:
DAWN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
P.A.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992000269
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/23/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6124 W PARKER RD
Provider Second Line Business Mailing Address:
SUITE 131
Provider Business Mailing Address City Name:
PLANO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75093-8122
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-778-1075
Provider Business Mailing Address Fax Number:
214-778-1237

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6124 W PARKER RD
Provider Second Line Business Practice Location Address:
SUITE 131
Provider Business Practice Location Address City Name:
PLANO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75093-8122
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-778-1075
Provider Business Practice Location Address Fax Number:
214-778-1237
Provider Enumeration Date:
01/18/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363AM0700X , with the licence number:  PA07069 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: PA07069 . This is a "TEXAS PA LICENSE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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