Provider Demographics
NPI:1366991457
Name:ECHOLS, IDA
Entity type:Individual
Prefix:
First Name:IDA
Middle Name:
Last Name:ECHOLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9777 W GULF BANK RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-3132
Mailing Address - Country:US
Mailing Address - Phone:832-693-0143
Mailing Address - Fax:
Practice Address - Street 1:16131 N. ELDRIDGE PKWY SUITE 200
Practice Address - Street 2:SUITE 5
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377
Practice Address - Country:US
Practice Address - Phone:281-970-5900
Practice Address - Fax:281-790-5913
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-29
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic