Provider Demographics
NPI:1922280155
Name:ERIC L HIGGINS DPM
Entity Type:Organization
Organization Name:ERIC L HIGGINS DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:LARRY
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:806-934-9503
Mailing Address - Street 1:PO BOX 245
Mailing Address - Street 2:
Mailing Address - City:DUMAS
Mailing Address - State:TX
Mailing Address - Zip Code:79029-0245
Mailing Address - Country:US
Mailing Address - Phone:806-934-9503
Mailing Address - Fax:806-934-1154
Practice Address - Street 1:222 S BLISS AVE
Practice Address - Street 2:
Practice Address - City:DUMAS
Practice Address - State:TX
Practice Address - Zip Code:79029-3806
Practice Address - Country:US
Practice Address - Phone:806-934-9503
Practice Address - Fax:806-934-1154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1672213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX163621901Medicaid
TXU93578Medicare UPIN
TX5778370001Medicare NSC
TXTXB116145Medicare PIN