Provider Demographics
NPI:1689675746
Name:EISENBERG, ROBERT S (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:S
Last Name:EISENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3636 N MACARTHUR BLVD
Mailing Address - Street 2:SUITE 135
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-3691
Mailing Address - Country:US
Mailing Address - Phone:972-258-8000
Mailing Address - Fax:972-258-8004
Practice Address - Street 1:3636 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 135
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-3691
Practice Address - Country:US
Practice Address - Phone:972-258-8000
Practice Address - Fax:972-258-8004
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0998207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110657702Medicaid
TX84V080Medicare PIN
TX110657702Medicaid
TX0229060001Medicare NSC