MEDICARE: ELI CORIA DO

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	207Q00000X	Family Medicine Physician	T7905	TX

General Provider Information

NPI Number	:	1831658996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELI CORIA DO

Provider Business Mailing Address
First Line	:	PO BOX 37
Second Line	:
City	:	BARKER
State	:	TX
Zip	:	77413-0037
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2750 FM 1463 RD STE 100
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-6894
Country	:	US
Telephone Number	:	832-658-3010
Fax Number	:

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

Provider Enumeration Date	:	03/18/2019
Last Update Date	:	09/16/2024

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Directions to “ ELI CORIA DO” Practice Location

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