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NPI Code Detail

MEDICARE: MR. DAVID LEE EUBANK LMFT, LPC-ASSOCIATE

MEDICARE:  MR. DAVID LEE EUBANK  LMFT, LPC-ASSOCIATE
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
1101YP2500XProfessional Counselor87786TX
2101Y00000XCounselor203442TX

General Provider Information

NPI Number : 1508591355
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID LEE EUBANK LMFT, LPC-ASSOCIATE
Provider Business Mailing Address
First Line : 417 SONARAN CT # 721
Second Line :
City : EL PASO
State : TX
Zip : 79932-1171
Country : US
Telephone Number : 915-301-2465
Fax Number :
Provider Business Practice Location Address
First Line : 16414 SAN PEDRO AVE STE 710
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78232-2247
Country : US
Telephone Number : 210-455-0581
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2022
Last Update Date : 07/17/2022

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Directions to “ MR. DAVID LEE EUBANK LMFT, LPC-ASSOCIATE” Practice Location

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