Erickson, Gary L.
Erickson, Gary L. is an sole proprietor health care provider with primary practice located at 2463 Forest Park Blvd , Fort Worth TX 76110-1731. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Erickson, Gary L. can be contacted via phone (817) 926-5287.Contact Information
Primary practice address
2463 Forest Park Blvd
Fort Worth TX 76110-1731
Phone: (817) 926-5287
Fax: (817) 926-5288
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 801 | Texas |
Profile Details
| NPI number | 1841290012 |
|---|---|
| LBN Legal business name | Erickson, Gary L. |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 28th, 2005 |
| Last updated | Jul 27th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841290012 | NPPES |
| Texas | MEDICAID | 018832801 |
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