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General NPI Number Information
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NPI Number | 1508911181
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Entity Type | Individual
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Provider Name | KATHRYN JEAN EUBANK M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 06/13/2012
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Provider Practice Location Address
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Address Line | 5323 HARRY HINES BLVD
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City | DALLAS
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State | TX
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Zip | 75390-7201
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Country | US
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Telephone | 214-648-2992
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Fax | 214-648-2087
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Provider Business Mailing Address
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Address Line | P.O. BOX 845347
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City | DALLAS
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State | TX
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Zip | 75284-5347
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Country | US
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Telephone | 214-648-2992
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Fax | 214-648-2087
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | D0056806
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | N7254
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | N7254
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License Number State | TX
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