Provider Demographics
NPI:1669799037
Name:EUBANKS, DELSON E
Entity type:Individual
Prefix:MR
First Name:DELSON
Middle Name:E
Last Name:EUBANKS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 RICE RD
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-3604
Mailing Address - Country:US
Mailing Address - Phone:903-509-4327
Mailing Address - Fax:903-509-4330
Practice Address - Street 1:455 RICE RD
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-3604
Practice Address - Country:US
Practice Address - Phone:903-509-4327
Practice Address - Fax:903-509-4330
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50564237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist