Provider Demographics
NPI:1225868854
Name:ALFREDO ERMAC JR MD PA
Entity type:Organization
Organization Name:ALFREDO ERMAC JR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:ERMAC
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:713-540-0840
Mailing Address - Street 1:13219 DOTSON RD STE 210
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4308
Mailing Address - Country:US
Mailing Address - Phone:281-957-4848
Mailing Address - Fax:833-973-3955
Practice Address - Street 1:13219 DOTSON RD STE 210
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4308
Practice Address - Country:US
Practice Address - Phone:281-955-0338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-07
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty