MEDICARE: DR. DIANA EISNER M.D.

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	174400000X	Specialist	E8452	TX

General Provider Information

NPI Number	:	1841386661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIANA EISNER M.D.

Provider Business Mailing Address
First Line	:	2030 N LOOP WEST
Second Line	:	SUITE 125
City	:	HOUSTON
State	:	TX
Zip	:	77018
Country	:	US
Telephone Number	:	713-688-8393
Fax Number	:	713-688-0595

Provider Business Practice Location Address
First Line	:	2030 N LOOP WEST
Second Line	:	SUITE 125
City	:	HOUSTON
State	:	TX
Zip	:	77018
Country	:	US
Telephone Number	:	713-688-8393
Fax Number	:	713-688-0595

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

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	07/08/2007

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