Provider Demographics
NPI:1992038129
Name:ERIK P SHULTZ MD PLLC
Entity Type:Organization
Organization Name:ERIK P SHULTZ MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:SHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-405-9857
Mailing Address - Street 1:7737 SOUTHWEST FWY STE 950
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1806
Mailing Address - Country:US
Mailing Address - Phone:870-405-9857
Mailing Address - Fax:713-448-5500
Practice Address - Street 1:7737 SOUTHWEST FWY STE 950
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1806
Practice Address - Country:US
Practice Address - Phone:870-405-9857
Practice Address - Fax:713-448-5500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE4623207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208365601OtherMEDICAID
ARP00280111OtherMEDICARE RAILROAD
5N410OtherAR BCBS #
AR1811936941OtherINDIVIDUAL NPI
5N410OtherMEDICARE PROVIDER #
AR158631001Medicaid
AR158631001Medicaid
AR=========OtherTRICARE
AR1811936941OtherINDIVIDUAL NPI