# EICHELBERGER MEDICAL PRACTICE, P.A.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073820254
- **Authorized official:** DR. PHILIP THEODRIC EICHELBERGER JR. M.D. (PRESIDENT)
- **Authorized official phone:** (281) 427-8502

## Contact information

- **Practice address:** 1610 JAMES BOWIE DRIVE, SUITE A103, BAYTOWN, TX 77520-3346
- **Practice address phone:** (281) 427-8502
- **Practice address fax:** (281) 420-5575
- **Mailing address:** 1610 JAMES BOWIE DRIVE, SUITE A103, BAYTOWN, TX 77520-3346
- **Mailing address phone:** (281) 427-8502
- **Mailing address fax:** (281) 420-5575

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | C6308 | TX | Yes |

## Other

- **Enumeration date:** 09/09/2010
- **Last updated:** 09/09/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 122199604 | — | TX |