Individual
DR. KENNETH LAWRENCE EISENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 MEDICAL CENTER DR, STE 212, EL PASO, TX 79902-5008
(915) 532-3977
(915) 532-5866
Mailing address
1600 MEDICAL CENTER DR, STE 212, EL PASO, TX 79902-5008
(915) 532-3977
(915) 532-5866
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
G1381
TX
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
G1381
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133925105
—
TX
Enumeration date
06/14/2005
Last updated
01/31/2011
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