MEDICARE: COREY JAMAL STERLING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1154925246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COREY JAMAL STERLING

Provider Business Mailing Address
First Line	:	510 AVENUE OF OAKS ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77009-1949
Country	:	US
Telephone Number	:	510-206-1159
Fax Number	:

Provider Business Practice Location Address
First Line	:	510 AVENUE OF OAKS ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77009-1949
Country	:	US
Telephone Number	:	510-206-1159
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2020
Last Update Date	:	11/30/2020

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Directions to “ COREY JAMAL STERLING ” Practice Location

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