Provider Demographics
NPI:1720097520
Name:EASTMAN, DENNIS PATRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:PATRICK
Last Name:EASTMAN
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 1:3420 22ND PL
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1314
Mailing Address - Country:US
Mailing Address - Phone:806-725-5844
Mailing Address - Fax:806-723-6532
Practice Address - Street 1:3606 21ST ST
Practice Address - Street 2:SUITE 103
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1226
Practice Address - Country:US
Practice Address - Phone:806-725-4425
Practice Address - Fax:806-723-7347
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6594208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX193636101Medicaid
8AU580OtherBLUE CROSS BLUE SHIELD
P00608395OtherMEDICARE RR
160284100OtherFIRST CARE
NM34651586Medicaid
160284100OtherFIRST CARE