Provider Demographics
NPI:1518276724
Name:CAMPA, ERIKA RENEE (SLP)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:RENEE
Last Name:CAMPA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12423 GARRETT CRK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-6080
Mailing Address - Country:US
Mailing Address - Phone:231-360-0158
Mailing Address - Fax:
Practice Address - Street 1:5900 EVERS RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-1606
Practice Address - Country:US
Practice Address - Phone:210-398-0236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-05
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34906235Z00000X
TX105797235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1518276724Medicaid