MEDICARE: ERICKSON HEALTH MEDICAL GROUP OF TEXAS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363L00000X	Nurse Practitioner
2	364S00000X	Clinical Nurse Specialist
3	207Q00000X	Family Medicine Physician
4	207RG0300X	Geriatric Medicine (Internal Medicine) Physician
5	213E00000X	Podiatrist
6	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1194961508
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERICKSON HEALTH MEDICAL GROUP OF TEXAS PA

Provider Business Mailing Address
First Line	:	5730 EXECUTIVE DR STE 230
Second Line	:
City	:	CATONSVILLE
State	:	MD
Zip	:	21228-1762
Country	:	US
Telephone Number	:	281-249-7100
Fax Number	:	281-249-7365

Provider Business Practice Location Address
First Line	:	14703 EAGLE VISTA DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-5275
Country	:	US
Telephone Number	:	281-249-7100
Fax Number	:	281-249-7365

Authorized Official
Title or Position	:	EXECUTIVE VP CMO
Name	:	MATTHEW J NARRETT
Credential	:	MD
Telephone Number	:	410-402-2261

Provider Enumeration Date	:	01/07/2009
Last Update Date	:	08/10/2023

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