Provider Demographics
NPI:1972669349
Name:ACOSTA, EDUARDO GALANG (MD)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:GALANG
Last Name:ACOSTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6521 GENESEO CIR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-1615
Mailing Address - Country:US
Mailing Address - Phone:972-783-0222
Mailing Address - Fax:972-783-1303
Practice Address - Street 1:375 MUNICIPAL DR
Practice Address - Street 2:SUITE 134
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3559
Practice Address - Country:US
Practice Address - Phone:972-783-0222
Practice Address - Fax:972-783-1303
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE7345208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1202491-03Medicaid
TX1202491-03Medicaid
00AN94Medicare PIN