Provider Demographics
NPI:1053858381
Name:CALZADA, ERIK (PT, ATC)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:
Last Name:CALZADA
Suffix:
Gender:M
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2741 FAUDREE RD APT 11203
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79765-2187
Mailing Address - Country:US
Mailing Address - Phone:915-820-4968
Mailing Address - Fax:
Practice Address - Street 1:2525 N GRANDVIEW AVE STE 400
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-1621
Practice Address - Country:US
Practice Address - Phone:432-550-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-25
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT74212255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer