Provider Demographics
NPI:1649409228
Name:EISENBERG, ALLISON ELAINE (APRN)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:ELAINE
Last Name:EISENBERG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:ALLISON
Other - Middle Name:ELAINE
Other - Last Name:FEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:5233 BELLAIRE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3901
Mailing Address - Country:US
Mailing Address - Phone:281-412-2494
Mailing Address - Fax:281-412-2495
Practice Address - Street 1:5233 BELLAIRE BLVD STE B
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3901
Practice Address - Country:US
Practice Address - Phone:281-412-2494
Practice Address - Fax:281-412-2495
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-05
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX705356363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX220642701Medicaid
TX220642701Medicaid