Provider Demographics
NPI:1891196143
Name:TOVAR-BEAVERS, ERICA ANN (DC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:ANN
Last Name:TOVAR-BEAVERS
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 1:6418 S STAPLES ST STE 142
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-2938
Mailing Address - Country:US
Mailing Address - Phone:361-855-0000
Mailing Address - Fax:361-882-9944
Practice Address - Street 1:6418 S STAPLES ST STE 142
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-2938
Practice Address - Country:US
Practice Address - Phone:361-855-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-05
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12726111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor