MEDICARE: PATRICK ALLAN EUBANKS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	84260	TX

General Provider Information

NPI Number	:	1427546381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK ALLAN EUBANKS

Provider Business Mailing Address
First Line	:	3401 S LAMAR BLVD APT 3346
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-2666
Country	:	US
Telephone Number	:	737-346-8734
Fax Number	:

Provider Business Practice Location Address
First Line	:	3401 S LAMAR BLVD APT 3346
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-2666
Country	:	US
Telephone Number	:	737-346-8734
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2018
Last Update Date	:	04/26/2018

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