Healthcare Provider Details

I. General information

NPI: 1891424719
Provider Name (Legal Business Name): ERIKA SANDOVAL LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIKA ORTIZ MARTINEZ LPC

II. Dates (important events)

Enumeration Date: 06/07/2022
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 EIDSON RD
EAGLE PASS TX
78852-5403
US

IV. Provider business mailing address

PO BOX 1470
EAGLE PASS TX
78853-1470
US

V. Phone/Fax

Practice location:
  • Phone: 830-757-6946
  • Fax: 830-757-5850
Mailing address:
  • Phone: 830-773-8917
  • Fax: 830-773-1892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number85550
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: