Provider Demographics
NPI:1376691865
Name:TICE-ESKOLA, TANYA YVONNE (PHARMD)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:YVONNE
Last Name:TICE-ESKOLA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:TANYA
Other - Middle Name:YVONNE
Other - Last Name:ESKOLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:853 COUNTY ROAD 209
Mailing Address - Street 2:
Mailing Address - City:LAMPASAS
Mailing Address - State:TX
Mailing Address - Zip Code:76550-3768
Mailing Address - Country:US
Mailing Address - Phone:512-525-3062
Mailing Address - Fax:
Practice Address - Street 1:36000 DARNALL LOOP
Practice Address - Street 2:CARL R. DARNALL ARMY MEDICAL CENTER
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-288-8824
Practice Address - Fax:254-288-8960
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29110183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist