Provider Demographics
NPI:1386703064
Name:ERKO, AMSALU (MD)
Entity type:Individual
Prefix:
First Name:AMSALU
Middle Name:
Last Name:ERKO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 W 45TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78751-3014
Mailing Address - Country:US
Mailing Address - Phone:512-451-5800
Mailing Address - Fax:512-459-1399
Practice Address - Street 1:3000 NORTH IH 35
Practice Address - Street 2:SUITE 635
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1804
Practice Address - Country:US
Practice Address - Phone:512-320-1500
Practice Address - Fax:512-320-1588
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5148207RN0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX207456906Medicaid
TX289122YR7HMedicare PIN
TXTXB137909Medicare PIN
8L18355Medicare PIN
TXTXB137906Medicare PIN
TX207456905Medicaid