Provider Demographics
NPI:1821621590
Name:LUPARDUS, ERICKA (DC)
Entity Type:Individual
Prefix:
First Name:ERICKA
Middle Name:
Last Name:LUPARDUS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 LIVE OAK LN
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-1788
Mailing Address - Country:US
Mailing Address - Phone:817-905-5362
Mailing Address - Fax:
Practice Address - Street 1:203 N TRINITY ST
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-1681
Practice Address - Country:US
Practice Address - Phone:817-905-5362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-20
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14203111NP0017X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor