Provider Demographics
NPI:1851300651
Name:TEPPER, ERIC R (DPM)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:R
Last Name:TEPPER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3143 HIGHWAY 6
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4367
Mailing Address - Country:US
Mailing Address - Phone:281-980-3668
Mailing Address - Fax:281-980-1124
Practice Address - Street 1:3143 HWY 6 SOUTH
Practice Address - Street 2:
Practice Address - City:SUGARLAND
Practice Address - State:TX
Practice Address - Zip Code:77478
Practice Address - Country:US
Practice Address - Phone:281-980-3668
Practice Address - Fax:281-980-1124
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0776213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX018800501Medicaid
TX018800501Medicaid
T16240Medicare UPIN