Provider Demographics
NPI:1215381793
Name:DORR, ERIN (CPM, LM)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:
Last Name:DORR
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 SHEFFIELD DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-5630
Mailing Address - Country:US
Mailing Address - Phone:903-508-9218
Mailing Address - Fax:903-526-2605
Practice Address - Street 1:421 S BONNER AVE
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-8034
Practice Address - Country:US
Practice Address - Phone:903-526-2605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99268175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay