Organization
DAN K. EIDMAN, MDPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN EIDMAN (CEO)
(713) 796-8595
Entity
Organization
Contact information
Practice address
6624 FANNIN ST STE 1510, 6624 FANNIN, STE 1510, HOUSTON, TX 77030-2393
(713) 796-8595
(713) 796-0813
Mailing address
6624 FANNIN ST STE 1510, 6624 FANNIN, STE 1510, HOUSTON, TX 77030-2393
(713) 796-8595
(713) 796-0813
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
E4316
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033288401
—
TX
Enumeration date
07/11/2012
Last updated
07/11/2012
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