Provider Demographics
NPI:1376703116
Name:WOHL, ERIC LOUIS (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:LOUIS
Last Name:WOHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7112 ED BLUESTEIN BLVD STE 155
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-2904
Mailing Address - Country:US
Mailing Address - Phone:512-972-4622
Mailing Address - Fax:512-972-4609
Practice Address - Street 1:7112 ED BLUESTEIN BLVD STE 155
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-2904
Practice Address - Country:US
Practice Address - Phone:512-972-4622
Practice Address - Fax:512-972-4609
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7676207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX112278003Medicaid