Provider Demographics
NPI:1902050883
Name:EUBANK, JIMMY BROWN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JIMMY
Middle Name:BROWN
Last Name:EUBANK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 TEAKWOOD LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-4420
Mailing Address - Country:US
Mailing Address - Phone:972-596-1811
Mailing Address - Fax:972-867-2219
Practice Address - Street 1:2101 TEAKWOOD LN
Practice Address - Street 2:SUITE 100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-4420
Practice Address - Country:US
Practice Address - Phone:972-596-1811
Practice Address - Fax:972-867-2219
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10394122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist