Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | N8645 | TX |
NPI | 1053511279 |
---|---|
Provider Name | Lauren Nicole Eisenberg |
First Address | El Paso, TX 79912-3508 |
Second Address | El Paso, TX 79912 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2007 |
Last Update Date | 01/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
N8645 | 1053511279 (01) | TX |