Provider Demographics
NPI:1053313163
Name:ERB, EDWARD L (DO)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:L
Last Name:ERB
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 HILL COUNTRY DR
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-6024
Mailing Address - Country:US
Mailing Address - Phone:830-258-7762
Mailing Address - Fax:830-258-7098
Practice Address - Street 1:575 HILL COUNTRY DR
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028
Practice Address - Country:US
Practice Address - Phone:830-258-7762
Practice Address - Fax:830-258-7098
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34006491E2086S0129X
TXR38362086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX381871801Medicaid
OH9343201Medicare PIN
OHG55521Medicare UPIN
OHG55521Medicare UPIN
OH0829339Medicare PIN