MEDICARE: DR. ERIC CHRISTIAN DREW M.D.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	L4911	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LOCATION CODE 052	OTHER	TX	TRICARE
2	8S6417	OTHER	TX	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578539839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC CHRISTIAN DREW M.D.

Provider Business Mailing Address
First Line	:	PO BOX 293690
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75029-3690
Country	:	US
Telephone Number	:	940-383-1770
Fax Number	:	940-566-2214

Provider Business Practice Location Address
First Line	:	4931 LONG PRAIRIE RD
Second Line	:	STE 100
City	:	FLOWER MOUND
State	:	TX
Zip	:	75028-2787
Country	:	US
Telephone Number	:	972-420-9200
Fax Number	:	972-436-4088

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	06/22/2021

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