Provider Demographics
NPI:1528874112
Name:CASPER, ERICA (BS, RDH)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:CASPER
Suffix:
Gender:F
Credentials:BS, RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12260 EMERALD MIST LN
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-1965
Mailing Address - Country:US
Mailing Address - Phone:715-297-6937
Mailing Address - Fax:
Practice Address - Street 1:114 VISION PARK BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-3008
Practice Address - Country:US
Practice Address - Phone:936-321-1477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist