Provider Demographics
NPI:1730873464
Name:CHUNGATA, ERICK JHOVANY
Entity type:Individual
Prefix:
First Name:ERICK
Middle Name:JHOVANY
Last Name:CHUNGATA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8521 VOGUE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-1130
Mailing Address - Country:US
Mailing Address - Phone:832-618-5605
Mailing Address - Fax:
Practice Address - Street 1:8521 VOGUE LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-1130
Practice Address - Country:US
Practice Address - Phone:832-618-5605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2175574225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant