Provider Demographics
NPI:1326681487
Name:MATHIS, ERIKA (CNM)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:MATHIS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 N WASHINGTON AVE STE 2700
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1735
Mailing Address - Country:US
Mailing Address - Phone:214-975-3937
Mailing Address - Fax:469-309-7787
Practice Address - Street 1:411 N WASHINGTON AVE STE 2700
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1735
Practice Address - Country:US
Practice Address - Phone:214-975-3937
Practice Address - Fax:469-309-7787
Is Sole Proprietor?:No
Enumeration Date:2019-10-22
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143650367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife