Provider Demographics
NPI:1295079986
Name:LYNCH, ERIKA RUTH
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:RUTH
Last Name:LYNCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 W PRESIDENT GEORGE BUSH HWY
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-1135
Mailing Address - Country:US
Mailing Address - Phone:817-271-6099
Mailing Address - Fax:844-881-5050
Practice Address - Street 1:1301 W PRESIDENT GEORGE BUSH HWY
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-1135
Practice Address - Country:US
Practice Address - Phone:817-271-6099
Practice Address - Fax:844-881-5050
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2023-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX713813363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX315348801Medicaid
TX315348801Medicaid
TX269730YKY6Medicare PIN