Provider Demographics
NPI:1447320122
Name:ERMALINSKI, RICHARD (PHD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:ERMALINSKI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SOUTHWESTERN BLVD
Mailing Address - Street 2:SUITE 113
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478
Mailing Address - Country:US
Mailing Address - Phone:281-242-0777
Mailing Address - Fax:281-242-0111
Practice Address - Street 1:101 SOUTHWESTERN BOULEVARD
Practice Address - Street 2:SUITE 113
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478
Practice Address - Country:US
Practice Address - Phone:281-242-0777
Practice Address - Fax:281-242-0111
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20854103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX055147OtherVALUE OPTIONS ID #
TX00L41BOtherBCBS ID#