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General NPI Number Information
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NPI Number | 1962855908
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Entity Type | Individual
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Provider Name | LAUREN EICHBLATT
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Gender | Female
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Dates
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Enumeration Date | 07/14/2016
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Last Update Date | 07/14/2016
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Provider Practice Location Address
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Address Line | 1015 W MEDICAL CENTER BLVD SUITE 1600
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City | WEBSTER
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State | TX
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Zip | 77598-4052
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Country | US
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Telephone | 281-338-9032
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Fax |
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Provider Business Mailing Address
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Address Line | 2106 HILLSIDE OAK LN
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City | HOUSTON
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State | TX
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Zip | 77062-3673
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Country | US
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Telephone | 832-647-6564
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 31994
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License Number State | TX
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