Provider Demographics
NPI:1316368921
Name:STEINKE, ERIC
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:STEINKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 S JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:MART
Mailing Address - State:TX
Mailing Address - Zip Code:76664-1515
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:116 S JOHNSON ST
Practice Address - Street 2:
Practice Address - City:MART
Practice Address - State:TX
Practice Address - Zip Code:76664-1515
Practice Address - Country:US
Practice Address - Phone:254-749-9694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-27
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1234689225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist