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Individual
DR. KENT ERICKSON
Active
Individual
DR. KENT ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L4924
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00J21A
GROUP MEDICARE NUMBER
TX
01
—
094010801
GROUP MEDICAID NUMBER
TX
05
—
153879506
—
TX
05
—
153879511
—
TX
05
—
153879512
—
TX
05
—
153879513
—
TX
Enumeration date
12/12/2006
Last updated
03/17/2018
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