Provider Demographics
NPI:1215916622
Name:DEVERA, ERLINDA (MD)
Entity type:Individual
Prefix:DR
First Name:ERLINDA
Middle Name:
Last Name:DEVERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:638 EAST MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:TX
Mailing Address - Zip Code:78382-3333
Mailing Address - Country:US
Mailing Address - Phone:361-729-0646
Mailing Address - Fax:361-729-8854
Practice Address - Street 1:638 EAST MARKET STREET
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:TX
Practice Address - Zip Code:78382-3333
Practice Address - Country:US
Practice Address - Phone:361-729-0646
Practice Address - Fax:361-729-8854
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7737207P00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC15131Medicare UPIN