Basic Information
Provider Information
NPI: 1013060433
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ERBEN
FirstName: DAVID
MiddleName: MARK
NamePrefix: MR.
NameSuffix:  
Credential: LOT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8868 RESEARCH BLVD
Address2: SUITE 601
City: AUSTIN
State: TX
PostalCode: 787586497
CountryCode: US
TelephoneNumber: 5124677232
FaxNumber: 5124677203
Practice Location
Address1: 8868 RESEARCH BLVD
Address2: SUITE 601
City: AUSTIN
State: TX
PostalCode: 787586497
CountryCode: US
TelephoneNumber: 5124677232
FaxNumber: 5124677203
Other Information
ProviderEnumerationDate: 01/19/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225XH1200X102879TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand

No ID Information.


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