Provider Demographics
NPI:1013448901
Name:FIEDLER, ERIN REBECCA (DO)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:REBECCA
Last Name:FIEDLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3417 GASTON AVE STE 935
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-2036
Mailing Address - Country:US
Mailing Address - Phone:469-800-7680
Mailing Address - Fax:
Practice Address - Street 1:3417 GASTON AVE STE 935
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2036
Practice Address - Country:US
Practice Address - Phone:469-800-7680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT53132084N0400X, 2084N0600X, 2084E0001X
IL0361551732084N0400X, 2084N0600X
IL1250706382084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084E0001XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyEpilepsy
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology