Individual
DR. ILYSE SAMANTHA KORNBLAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4500 S LANCASTER RD, DALLAS, TX 75216-7167
(214) 742-8387
(214) 857-2828
Mailing address
4500 S LANCASTER RD, DALLAS, TX 75216-7167
(214) 742-8387
(214) 857-2828
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
59116
TN
207W00000X
Ophthalmology Physician
BP20054251
TX
207W00000X
Ophthalmology Physician
HSE26017
FL
Other
Enumeration date
04/10/2014
Last updated
04/24/2024
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