MEDICARE: JOSEPH N CORRIERE M.D.

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	208800000X	Urology Physician	E2178	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	81Z022	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1689609786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH N CORRIERE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 201088
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77216-1088
Country	:	US
Telephone Number	:	713-500-3500
Fax Number	:	713-500-5484

Provider Business Practice Location Address
First Line	:	1220 HOLCOMBE BLVD
Second Line	:	UNIT 1274
City	:	HOUSTON
State	:	TX
Zip	:	77030-4004
Country	:	US
Telephone Number	:	713-745-7060
Fax Number	:

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	07/08/2007

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