Provider Demographics
NPI:1487956447
Name:PLUNKETT, ERIC LORENZO
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:LORENZO
Last Name:PLUNKETT
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:ERIC
Other - Middle Name:LORENZO
Other - Last Name:PLUNKETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FA
Mailing Address - Street 1:10800 STATE HIGHWAY 151 APT 124
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4209
Mailing Address - Country:US
Mailing Address - Phone:210-647-1907
Mailing Address - Fax:210-647-1810
Practice Address - Street 1:10800 STATE HIGHWAY 151 APT 124
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4209
Practice Address - Country:US
Practice Address - Phone:210-647-1907
Practice Address - Fax:210-647-1810
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-24
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant