Provider Demographics
NPI:1427079300
Name:ZWERNEMANN, ERICA J (MD)
Entity type:Individual
Prefix:DR
First Name:ERICA
Middle Name:J
Last Name:ZWERNEMANN
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 1:731 E SOUTHLAKE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6377
Mailing Address - Country:US
Mailing Address - Phone:817-912-8800
Mailing Address - Fax:817-912-8810
Practice Address - Street 1:731 E SOUTHLAKE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6377
Practice Address - Country:US
Practice Address - Phone:817-912-8800
Practice Address - Fax:817-912-8810
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0731208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX85496XOtherBCBS
TX045546101Medicaid
TX045546102Medicaid
TXH21497Medicare UPIN
TX045546102Medicaid
TX8G4734Medicare PIN