Provider Demographics
NPI:1578539839
Name:DREW, ERIC CHRISTIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:CHRISTIAN
Last Name:DREW
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:PO BOX 293690
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75029-3690
Mailing Address - Country:US
Mailing Address - Phone:940-383-1770
Mailing Address - Fax:940-566-2214
Practice Address - Street 1:4931 LONG PRAIRIE RD
Practice Address - Street 2:STE 100
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2787
Practice Address - Country:US
Practice Address - Phone:972-420-9200
Practice Address - Fax:972-436-4088
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL49112084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXLOCATION CODE 052OtherTRICARE
TX8S6417OtherBCBS
TX159040803Medicaid
TXQ42095Medicare UPIN
TXLOCATION CODE 052OtherTRICARE
TX8J5228Medicare PIN