ECLIPSE CLINIC PLLC NPI 1710551585

NPI Information

NPI: 1710551585
Provider Name: ECLIPSE CLINIC PLLC
Classification: Physical Medicine & Rehabilitation - 2081P2900X
Entity Type: Organization

Specialization: Pain Medicine

CLIA Number: 45D2204990

Address:
1006 LEGACY RANCH RD
104
WAXAHACHIE, TX
ZIP 75165
Phone: (817) 826-4604
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ECLIPSE CLINIC PLLC is a pain medicine physical medicine rehabilitation in Waxahachie, TX. The provider is a physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. ECLIPSE CLINIC PLLC NPI is 1710551585. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1006 LEGACY RANCH RD
104
WAXAHACHIE, TX
ZIP 75165
Phone: (817) 826-4604

The provider's authorized official is Dustin Leek .
The authorized official title is Sole Member and has the following contact phone number (817) 526-4604.

The CLIA number assigned to this NPI record is 45D2204990 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/17/2021 and was last updated on 5/17/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2081P2900X	Physical Medicine & Rehabilitation	Pain Medicine			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	15016694	OTHER	TEXAS	CAQH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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