Provider Demographics
NPI:1740215375
Name:EISENBERG, MICHELLE (DO)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:EISENBERG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11920 ASTORIA BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-6097
Mailing Address - Country:US
Mailing Address - Phone:281-464-2300
Mailing Address - Fax:281-464-2305
Practice Address - Street 1:11920 ASTORIA BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-6097
Practice Address - Country:US
Practice Address - Phone:281-464-2300
Practice Address - Fax:281-464-2305
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2314207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G2234Medicare PIN
I15737Medicare UPIN