Provider Demographics
NPI:1316555022
Name:BUFFINGTON, ERIC MARTELL (SPECIALIST)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:MARTELL
Last Name:BUFFINGTON
Suffix:
Gender:M
Credentials:SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16811 FONDNESS PARK DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-6928
Mailing Address - Country:US
Mailing Address - Phone:832-894-4492
Mailing Address - Fax:
Practice Address - Street 1:16811 FONDNESS PARK DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-6928
Practice Address - Country:US
Practice Address - Phone:832-894-4492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty