Healthcare Provider Details

I. General information

NPI: 1588614093
Provider Name (Legal Business Name): ERIC M ALCARAZ D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 10/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4141 SOUTHWEST FWY 410
HOUSTON TX
77027-7313
US

IV. Provider business mailing address

4141 SOUTHWEST FWY
HOUSTON TX
77027-7313
US

V. Phone/Fax

Practice location:
  • Phone: 713-626-2334
  • Fax:
Mailing address:
  • Phone: 713-626-2334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberN7670
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number02003003A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: