Provider Demographics
NPI:1225535669
Name:LUSE, ERICA MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:MICHELLE
Last Name:LUSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:MICHELLE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6701 FANNIN ST STE 610.25
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2609
Mailing Address - Country:US
Mailing Address - Phone:832-822-3230
Mailing Address - Fax:
Practice Address - Street 1:6701 FANNIN ST STE 610.25
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2609
Practice Address - Country:US
Practice Address - Phone:832-822-3230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.073590207W00000X
390200000X
TXT7742207WX0110X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program