Provider Demographics
NPI:1164878492
Name:DAVANIAN, ERICA (DO)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:DAVANIAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:EIRING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:621 N HALL ST STE 100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75226-1305
Mailing Address - Country:US
Mailing Address - Phone:214-821-9600
Mailing Address - Fax:214-823-5290
Practice Address - Street 1:621 N HALL ST STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75226-1305
Practice Address - Country:US
Practice Address - Phone:214-821-9600
Practice Address - Fax:214-823-5290
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU44942086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery