Provider Demographics
NPI:1174645972
Name:LORENTZ, ERICA (MED)
Entity Type:Individual
Prefix:MS
First Name:ERICA
Middle Name:
Last Name:LORENTZ
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 HAZARD STREET
Mailing Address - Street 2:#2
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019
Mailing Address - Country:US
Mailing Address - Phone:713-520-0689
Mailing Address - Fax:
Practice Address - Street 1:2501 HAZARD STREET
Practice Address - Street 2:#2
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019
Practice Address - Country:US
Practice Address - Phone:713-520-0689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLPC9380101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional