Peter Erickson, M.D.
Individual provider Active NPI Medical Toxicology (Preventive Medicine) Physician · Boling, TX
NPI 1902020332 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1902020332
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Toxicology (Preventive Medicine) Physician 2083T0002X
- License
- E5746 (TX)
- Practice address
- 120 Railroad St.
Boling, TX 77420 - Phone
- (979) 657-4000
- Fax
- (979) 657-3800
- NPI assigned
- Apr 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E5746 | TX | MD | Medical Toxicology (Preventive Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longevity Medicine, PLLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Toxicology (Preventive Medicine) Physician | 2083T0002X | E5746 | TX | Yes |
Addresses
Primary practice location
120 Railroad St.
Boling, TX 77420
Mailing address
PO Box 700
Boling, TX 77420-0700
Other providers in Boling, TX
- Cynthia Tedder Barnes
- Better Solutions LLC
- Boling Isd
- El Campo Memorial Hospital
- Larasha Renee Felder
- Longevity Medicine, PLLC
- Samantha Marie Tabares
All providers in Boling, TX · Medical Toxicology (Preventive Medicine) Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.