Healthcare Provider Details

I. General information

NPI: 1609871862
Provider Name (Legal Business Name): SUSAN T ERIE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9511 HUFFMEISTER RD STE 100
HOUSTON TX
77095-2865
US

IV. Provider business mailing address

PO BOX 392929 STE 200
PITTSBURGH PA
15251-0001
US

V. Phone/Fax

Practice location:
  • Phone: 713-461-2915
  • Fax: 713-461-5307
Mailing address:
  • Phone: 713-461-2915
  • Fax: 713-461-5307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberJ1989
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: