Provider Demographics
NPI:1346533379
Name:LOEHMKE PHELAN, ERIKA (PSYD)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:LOEHMKE PHELAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 KINGWOOD DR # 154
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-4473
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4314 YOAKUM BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5818
Practice Address - Country:US
Practice Address - Phone:713-850-0049
Practice Address - Fax:713-627-7302
Is Sole Proprietor?:No
Enumeration Date:2011-05-24
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34731103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX88249AOtherBCBS TX
TXP00947823OtherRR MCR
TX34731OtherLICENSE
TX281617501Medicaid