Provider Demographics
NPI:1245597087
Name:WAIT, ERIN NICOLE (MD)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:NICOLE
Last Name:WAIT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 W HWY 6 STE 101
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-5592
Mailing Address - Country:US
Mailing Address - Phone:254-772-5454
Mailing Address - Fax:
Practice Address - Street 1:601 W HWY 6 STE 101
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-5592
Practice Address - Country:US
Practice Address - Phone:254-772-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR6932207V00000X
AL33064207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL206148Medicaid