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General NPI Number Information
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NPI Number | 1144259656
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Entity Type | Individual
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Provider Name | ALLAN M EISENBAUM MD
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Gender | Male
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 11/18/2013
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Provider Practice Location Address
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Address Line | 3601 4TH ST STE 2A100
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City | LUBBOCK
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State | TX
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Zip | 79430-7217
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Country | US
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Telephone | 806-743-2020
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Fax | 806-743-1782
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Provider Business Mailing Address
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Address Line | PO BOX 5865
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City | LUBBOCK
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State | TX
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Zip | 79408-5865
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Country | US
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Telephone | 806-743-2898
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Fax | 806-743-2787
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 22433
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 44326
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License Number State | TX
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