Individual
EDWARD RANDOLPH ECKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12221 N MOPAC EXPRESSWAY, NAMC DEPARTMENT OF PATHOLOGY, AUSTIN, TX 78758
(512) 901-1206
(512) 901-1299
Mailing address
PO BOX 164106, AUSTIN, TX 78716-4106
(512) 901-1206
(512) 901-1299
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
07208R
LA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
G8089
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
124423802
CSHCN
TX
05
—
124423803
—
TX
05
—
124423805
—
TX
01
—
80P644
BCBS OF TEXAS
—
Enumeration date
11/07/2005
Last updated
02/16/2009
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