Healthcare Provider Details

I. General information

NPI: 1902089873
Provider Name (Legal Business Name): ERICK D. ALANIS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2007
Last Update Date: 12/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEJIA 745 - 5
JUAREZ CHIHUAHUA
32000
MX

IV. Provider business mailing address

1120 WILL RAND DR
EL PASO TX
79912-7620
US

V. Phone/Fax

Practice location:
  • Phone: 915-727-7588
  • Fax:
Mailing address:
  • Phone: 915-449-8589
  • Fax: 915-833-8796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4913280
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: