DR. KENT ERICKSON (NPI# 1336209873) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336209873 |
| Entity Type | Individual |
| Full Name | DR. KENT ERICKSON |
| Credential | MD |
| Practice Address |
17183 I 45 S Ste 550 Shenandoah TX 77385-3314 |
| Practice Telephone | 9362703800 |
| Mailing Telephone | 9362703800 |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | L4924 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 153879512 | 05 | |
| TX | 153879513 | 05 | |
| TX | 153879511 | 05 | |
| TX | GROUP MEDICAID NUMBER | 094010801 | 01 |
| TX | GROUP MEDICARE NUMBER | 00J21A | 01 |
| TX | 153879506 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 106 Vision Park Blvd, Shenandoah, TX 773843000 | 7134421800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073516035 | Kent Edwin Erickson | Family Medicine | 409 Lincoln Ave, Erickson Medical Clinic, LLC, Clay Center, KS 67432-2907 | 2005-05-24 |
| 1740217694 | Kent James Erickson | Chiropractor | 5740 Brooklyn Boulevard, 100, Brooklyn Center, MN 55429 | 2006-06-27 |
| Street Address |
17183 I 45 S STE 550 |
| City | SHENANDOAH |
| State | TX |
| Zip Code | 77385-3314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245490523 | Hardeep Gill | Internal Medicine | 17183 I 45 S Ste 550, Shenandoah, TX 77385-3314 | 2008-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134727423 | Victoria Templeton | Marriage & Family Therapist | 256 Ed English Dr., Building 4, Unit C, Shenandoah, TX 77385 | 2020-10-09 |
| 1760089296 | Mark Evar Espiritu Ogbac | Specialist/Technologist, Other | 2119 Pacific Loon Lane, Conroe, TX 77385 | 2020-10-07 |
| 1285255380 | Tiffany Tran | Pharmacist | 10200 Hwy 242, Conroe, TX 77385 | 2020-04-29 |
| 1447898994 | Harper's Preserve Dentistry, PC | Dentist | 10160 Hwy 242, Ste 100, Conroe, TX 77385 | 2019-12-16 |
| 1104462753 | Over The Moon Pediatrics, Pllc | Pediatrics | 17189 I-45 South, Suite 235, The Woodlands, TX 77385 | 2019-11-19 |
| 1053973453 | Mark William Riepl | Behavior Technician | 19445 David Memorial Dr, Unit #1707, Shenandoah, TX 77385 | 2019-07-05 |
| 1225690134 | H-e-b, Lp | Clinical Medical Laboratory | 10200 Highway 242, Conroe, TX 77385 | 2019-07-01 |
| 1932766235 | Houston Mint Dentistry, Pllc | Dentist | 19073 Interstate 45 N Suite 185, Shenandoah, TX 77385 | 2019-05-22 |
| 1255808283 | Ntn Dental Pllc | Clinic/Center | 10161 Highway 242, Suite 100, Conroe, TX 77385 | 2018-10-29 |
| 1164902094 | Lindsay Taylor Fleming | Specialist/Technologist | 19221, Interstate 45 S. Ste. 120, Shenandoah, TX 77385 | 2018-08-20 |
| Find all providers in zip 77385 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487867669 | Sachin Chandra Senan | Family Medicine | 129 Vision Park Blvd Ste 205, Shenandoah, TX 77384-3024 | 2007-05-07 |
| 1356463483 | James Wei-tzer Hu Md PC | Family Medicine | 239 W. Center St, Shenandoah, PA 17976-1608 | 2007-04-06 |
| 1154481034 | Christine M. Choi | Family Medicine | 9201 Pinecroft Dr Ste 220, Shenandoah, TX 77380-3889 | 2006-12-11 |
| 1699868968 | Richard Montgomery Brothers | Family Medicine | 424 S 3rd St, Shenandoah, VA 22849-1714 | 2006-10-01 |
| 1003853276 | Nora Catherine Hart | Family Medicine | 17183 I H 45 S Ste 550, Shenandoah, TX 77385 | 2006-05-31 |
| 1346208279 | Leena Chacko | Family Medicine | 129 Vision Park Blvd Ste 105, Shenandoah, TX 77384-3024 | 2006-05-02 |
| 1578537312 | Veronica Pina Bugenhagen | Family Medicine | 150 Pine Forest Dr Ste 703, Shenandoah, TX 77384 | 2006-02-16 |
| 1326028366 | James Wei-tzer Hu | Family Medicine | 239 W Center St, Shenandoah, PA 17976-1608 | 2006-01-17 |
| 1407488521 | Evelyn A Laryea | Family Medicine | 17201 Interstate 45 S, Shenandoah, TX 77385-3311 | 2020-02-06 |
| 1770038549 | Geriatric & Palliative Care Associates,pa | Family Medicine | 150 Pine Forest Dr, Suite 110, Shenandoah, TX 77384-5302 | 2016-08-22 |
| Find all providers in SHENANDOAH | ||||
| City | SHENANDOAH |
| Zip Code | 77385 |
Please comment or provide details below to improve the information on DR. KENT ERICKSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.