MEDICARE: ERICA LYNN SWICEGOOD 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	2084P0800X	Psychiatry Physician	N8248	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8DC927	OTHER	TX	BLUE CROSS BLUE SHIELD NUMBER

General Provider Information

NPI Number	:	1720272727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA LYNN SWICEGOOD M.D.

Provider Business Mailing Address
First Line	:	3840 HULEN ST
Second Line	:	HULENTOWER NORTH
City	:	FORT WORTH
State	:	TX
Zip	:	76107-7277
Country	:	US
Telephone Number	:	817-569-4300
Fax Number	:	817-569-4494

Provider Business Practice Location Address
First Line	:	3840 HULEN ST
Second Line	:	HULENTOWER NORTH
City	:	FORT WORTH
State	:	TX
Zip	:	76107-7277
Country	:	US
Telephone Number	:	817-569-4300
Fax Number	:	817-569-4494

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

Provider Enumeration Date	:	09/02/2007
Last Update Date	:	04/30/2013

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