Provider Demographics
NPI:1962511899
Name:TRUE, ERIC CHRISTOPHER (PA-C)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:CHRISTOPHER
Last Name:TRUE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 HANKS ST
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-5411
Mailing Address - Country:US
Mailing Address - Phone:936-633-2400
Mailing Address - Fax:936-633-2403
Practice Address - Street 1:1503 HANKS ST
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-5411
Practice Address - Country:US
Practice Address - Phone:936-633-2400
Practice Address - Fax:936-633-2403
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03085363AS0400X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080356101Medicaid
CJ8921OtherPALMETTO GBA RAILROAD MEDICARE
CJ8921OtherPALMETTO GBA RAILROAD MEDICARE
TXP40197Medicare UPIN