MEDICARE: DR. EILEEN K STARBRANCH MD

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	2084P0800X	Psychiatry Physician	E3150	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	88510F	OTHER	TX	BLUE CROSS

General Provider Information

NPI Number	:	1982671590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EILEEN K STARBRANCH MD

Provider Business Mailing Address
First Line	:	2600 N GESSNER
Second Line	:	SUITE 280
City	:	HOUSTON
State	:	TX
Zip	:	77080
Country	:	US
Telephone Number	:	713-468-6538
Fax Number	:	713-468-1042

Provider Business Practice Location Address
First Line	:	2600 N GESSNER
Second Line	:	SUITE 280
City	:	HOUSTON
State	:	TX
Zip	:	77080
Country	:	US
Telephone Number	:	713-468-6538
Fax Number	:	713-468-1042

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

Provider Enumeration Date	:	03/02/2006
Last Update Date	:	01/09/2008

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