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General NPI Number Information
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NPI Number | 1821029307
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Entity Type | Individual
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Provider Name | JUDITH G ERICKSON MD
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Gender | Female
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 05/25/2021
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Provider Practice Location Address
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Address Line | 14860 MONTFORT DR SUITE 115, LB 32
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City | DALLAS
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State | TX
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Zip | 75254-6873
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Country | US
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Telephone | 469-431-5656
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Fax | 877-658-8663
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Provider Business Mailing Address
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Address Line | 14860 MONTFORT DR SUITE 115, LB 32
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City | DALLAS
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State | TX
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Zip | 75254-6873
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Country | US
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Telephone | 214-550-1469
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Fax | 214-446-6010
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | L2875
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License Number State | TX
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