Healthcare Provider Details

I. General information

NPI: 1467320879
Provider Name (Legal Business Name): ERIC MICHAEL DIXON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 JOE BATTLE BLVD
EL PASO TX
79936-0962
US

IV. Provider business mailing address

1840 JOE BATTLE BLVD
EL PASO TX
79936-0962
US

V. Phone/Fax

Practice location:
  • Phone: 915-249-4344
  • Fax: 915-307-2765
Mailing address:
  • Phone: 915-249-4344
  • Fax: 915-307-2765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1216359
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: