Provider Demographics
NPI:1033539952
Name:CODD, ELIZA BETH (ARNP)
Entity type:Individual
Prefix:MISS
First Name:ELIZA
Middle Name:BETH
Last Name:CODD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:150 PINE FOREST DR STE 703
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77384-5317
Mailing Address - Country:US
Mailing Address - Phone:281-939-5915
Mailing Address - Fax:
Practice Address - Street 1:150 PINE FOREST DR STE 703
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-5317
Practice Address - Country:US
Practice Address - Phone:281-939-5915
Practice Address - Fax:281-982-1808
Is Sole Proprietor?:No
Enumeration Date:2014-04-17
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX841559363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily