Provider Demographics
NPI:1891137584
Name:SMALL, ERICKA (ARNP)
Entity type:Individual
Prefix:
First Name:ERICKA
Middle Name:
Last Name:SMALL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 W SAM HOUSTON PKWY N STE 220
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77041-8224
Mailing Address - Country:US
Mailing Address - Phone:713-402-7824
Mailing Address - Fax:713-570-0196
Practice Address - Street 1:4700 W SAM HOUSTON PKWY N STE 220
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77041-8224
Practice Address - Country:US
Practice Address - Phone:713-402-7824
Practice Address - Fax:713-570-0196
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9246855363L00000X, 363LF0000X
TX1094539363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009261300Medicaid
FLHL751ZMedicare PIN