Provider Demographics
NPI:1982773065
Name:EAKER FAMILY MEDICINE PA
Entity type:Organization
Organization Name:EAKER FAMILY MEDICINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:EAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:325-235-0770
Mailing Address - Street 1:301 JENNY GEORGE LN
Mailing Address - Street 2:
Mailing Address - City:SWEETWATER
Mailing Address - State:TX
Mailing Address - Zip Code:79556-7152
Mailing Address - Country:US
Mailing Address - Phone:325-235-0770
Mailing Address - Fax:325-235-0771
Practice Address - Street 1:301 JENNY GEORGE LN
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:TX
Practice Address - Zip Code:79556-7152
Practice Address - Country:US
Practice Address - Phone:325-235-0770
Practice Address - Fax:325-235-0771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7363207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI01602Medicare UPIN
TX00263ZMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER