Provider Demographics
NPI:1144406729
Name:WEBB, ERIN (PA)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:WEBB
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:WICKLIFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:SUITE 1101
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-441-0006
Mailing Address - Fax:713-790-2727
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SUITE 1101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-441-0006
Practice Address - Fax:713-790-2727
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05635363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8Y5016OtherBLUE CROSS BLUE SHIELD
TX193369902Medicaid
TXP01186469OtherRR MEDICARE
TX193369901Medicaid
TX193369905Medicaid
TXP00725046OtherRAILROAD MEDICARE
TX193369906Medicaid
TX193369902Medicaid
TX8K8142Medicare PIN