Individual
ALLAN M EISENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3601 4TH ST, STE 2A100, LUBBOCK, TX 79430-7217
(806) 743-2020
(806) 743-1782
Mailing address
PO BOX 5865, LUBBOCK, TX 79408-5865
(806) 743-2898
(806) 743-2787
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
22433
KS
207W00000X
Ophthalmology Physician
Primary
44326
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100198520B
—
KS
01
—
119954
COVENTRY
KS
01
—
13883
PHS
KS
05
—
196320901
—
TX
01
—
205163
HPK
KS
01
—
53746872
MULTIPLAN
KS
01
—
650862
BCBS
KS
Enumeration date
06/30/2006
Last updated
11/18/2013
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