Basic Information
Provider Information
NPI: 1174052815
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DEAL
FirstName: ERIC
MiddleName: LAWRENCE
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 BAYLOR PLZ # BCM620
Address2:  
City: HOUSTON
State: TX
PostalCode: 770303411
CountryCode: US
TelephoneNumber: 7137984951
FaxNumber:  
Practice Location
Address1: 7200 CAMBRIDGE ST FL 10
Address2:  
City: HOUSTON
State: TX
PostalCode: 770304202
CountryCode: US
TelephoneNumber: 7137984736
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/07/2017
LastUpdateDate: 06/17/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/17/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XS5594TXN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000XBP10060324TXN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RE0101XS5594TXY Allopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism

No ID Information.


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