Individual
DANIEL R. EICKENHORST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
816 W CANNON ST, FORT WORTH, TX 76104-3146
(817) 321-0937
(469) 522-6889
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101258011
VA
2085R0202X
Diagnostic Radiology Physician
Primary
Q0250
TX
Other
Enumeration date
05/21/2010
Last updated
07/06/2017
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