Individual
ERNST ETIENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
6565 FANNIN ST # B452, HOUSTON, TX 77030-2703
(713) 441-3620
Mailing address
6565 FANNIN ST # B452, HOUSTON, TX 77030-2703
(713) 441-3620
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA03422
TX
363A00000X
Physician Assistant
Primary
PA9116247
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
185010901
—
TX
05
—
185010902
—
TX
05
—
185010903
—
TX
01
—
8Y1362
BLUE CROSS BLUE SHIELD
TX
01
—
P00387792
RAILROAD MEDICARE
TX
01
—
P01074751
RR MEDICARE
TX
01
—
P01254101
MEDICARE RR
TX
Enumeration date
12/21/2006
Last updated
12/20/2022
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