Provider Demographics
NPI:1124124573
Name:LERMA, DANIEL A (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:A
Last Name:LERMA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 TRAWOOD DR
Mailing Address - Street 2:STE A1
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-3372
Mailing Address - Country:US
Mailing Address - Phone:915-593-2909
Mailing Address - Fax:915-633-9766
Practice Address - Street 1:2112 TRAWOOD DR
Practice Address - Street 2:STE A1
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-3372
Practice Address - Country:US
Practice Address - Phone:915-593-2909
Practice Address - Fax:915-633-9766
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6379111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U51994Medicare UPIN
611583Medicare ID - Type Unspecified