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General NPI Number Information
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NPI Number | 1871800888
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Entity Type | Individual
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Provider Name | ERICK HENRY PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/13/2010
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Last Update Date | 11/21/2012
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Provider Practice Location Address
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Address Line | 815 MARKET ST
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City | GALVESTON
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State | TX
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Zip | 77550-2725
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Country | US
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Telephone | 409-770-6600
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Fax | 409-770-6919
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Provider Business Mailing Address
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Address Line | PO BOX 8500 LOCKBOX 7642
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City | PHILADELPHIA
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State | PA
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Zip | 19178-7642
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Country | US
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Telephone | 813-281-8115
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Fax | 813-281-8656
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA06629
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License Number State | TX
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