Provider Demographics
NPI:1801404728
Name:KOETTER, ERIN (OD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:
Last Name:KOETTER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5832 DARLING ST UNIT 5
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-1089
Mailing Address - Country:US
Mailing Address - Phone:281-636-5741
Mailing Address - Fax:
Practice Address - Street 1:2799 KATY FWY STE 240
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-4629
Practice Address - Country:US
Practice Address - Phone:281-636-5741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-16
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9974T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist