Provider Demographics
NPI:1255996385
Name:PELOTE, ERICA L (MD)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:L
Last Name:PELOTE
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 1:18951 N MEMORIAL DR STE 103W
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4217
Mailing Address - Country:US
Mailing Address - Phone:281-540-8409
Mailing Address - Fax:
Practice Address - Street 1:18951 N MEMORIAL DR STE 103W
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4217
Practice Address - Country:US
Practice Address - Phone:281-540-8409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-03
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXV3408207R00000X, 208M00000X
AL44209208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine