Provider Demographics
NPI:1558400812
Name:ZIMMERMAN, ERIKA IRENE (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:IRENE
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6448 E HWY 290
Mailing Address - Street 2:SUITE # D-103
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1068
Mailing Address - Country:US
Mailing Address - Phone:512-452-2100
Mailing Address - Fax:512-452-2106
Practice Address - Street 1:6448 E HWY 290
Practice Address - Street 2:SUITE # D-103
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-1068
Practice Address - Country:US
Practice Address - Phone:512-452-2100
Practice Address - Fax:512-452-2106
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6829207Q00000X, 207QG0300X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG37992Medicare UPIN