Provider Demographics
NPI:1033227673
Name:BURDEN, ERICA E (PHD)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:E
Last Name:BURDEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5794
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77325-5794
Mailing Address - Country:US
Mailing Address - Phone:877-760-5437
Mailing Address - Fax:877-760-5437
Practice Address - Street 1:1521 GREEN OAK PL STE 250
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2044
Practice Address - Country:US
Practice Address - Phone:281-657-6052
Practice Address - Fax:877-760-5437
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-3834103T00000X, 103G00000X, 103T00000X
PAPS016206103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX039241703Medicaid
TX8J7109Medicare PIN
TX81875PMedicare ID - Type Unspecified
TX039241701Medicaid