Provider Demographics
NPI:1710939335
Name:LOPOSER, ERIC T (CO LPO)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:T
Last Name:LOPOSER
Suffix:
Gender:M
Credentials:CO LPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 WEST SHORE DRIVE
Mailing Address - Street 2:SUITE 400D
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080
Mailing Address - Country:US
Mailing Address - Phone:972-470-0300
Mailing Address - Fax:972-470-0301
Practice Address - Street 1:1110 WEST SHORE DRIVE
Practice Address - Street 2:SUITE 400D
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080
Practice Address - Country:US
Practice Address - Phone:972-470-0300
Practice Address - Fax:972-470-0301
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX339224P00000X, 222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145660001Medicaid
TX339OtherORTHOTIST/PROSTHETIST
TX339OtherTEXAS BOARD OF O & P
TX4225080001Medicare ID - Type UnspecifiedO AND P