Provider Demographics
NPI:1598039240
Name:HERRERA, ERIC PAUL
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:PAUL
Last Name:HERRERA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4436 NW 50TH
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-7627
Mailing Address - Country:US
Mailing Address - Phone:405-810-9578
Mailing Address - Fax:405-810-9597
Practice Address - Street 1:4436 NW 50TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-2212
Practice Address - Country:US
Practice Address - Phone:405-810-9578
Practice Address - Fax:405-810-9597
Is Sole Proprietor?:No
Enumeration Date:2012-02-27
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor