Provider Demographics
NPI:1326541087
Name:ROBERT M BIRENBAUM OD PC
Entity Type:Organization
Organization Name:ROBERT M BIRENBAUM OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:BIRENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:OD/OWNER
Authorized Official - Phone:214-924-3026
Mailing Address - Street 1:4919 STONY FORD DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-7236
Mailing Address - Country:US
Mailing Address - Phone:214-924-3026
Mailing Address - Fax:832-934-1161
Practice Address - Street 1:3128 FOREST LN STE 252
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7764
Practice Address - Country:US
Practice Address - Phone:972-243-3373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-08
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty