Provider Demographics
NPI:1245394519
Name:EISENBERG, DAVID HOWARD (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:HOWARD
Last Name:EISENBERG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2572 TARPLEY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-2328
Mailing Address - Country:US
Mailing Address - Phone:972-418-0788
Mailing Address - Fax:972-417-0857
Practice Address - Street 1:2572 TARPLEY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-2328
Practice Address - Country:US
Practice Address - Phone:972-418-0788
Practice Address - Fax:972-417-0857
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0975213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT13144Medicare UPIN
TX8F21970Medicare PIN
TX00JD93Medicare ID - Type Unspecified