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NPI Code Detail

MEDICARE: JERALD COLEMAN

MEDICARE: JERALD COLEMAN
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1902756604
Entity Type Code : Individual
Provider Name (Legal Business Name) : JERALD COLEMAN
Provider Business Mailing Address
First Line : 16415 LAZY RIDGE RD
Second Line :
City : HOUSTON
State : TX
Zip : 77053-4656
Country : US
Telephone Number : 832-489-5906
Fax Number : 832-489-5906
Provider Business Practice Location Address
First Line : 16415 LAZY RIDGE RD
Second Line :
City : HOUSTON
State : TX
Zip : 77053-4656
Country : US
Telephone Number : 832-489-5906
Fax Number : 832-489-5906
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2026
Last Update Date : 02/02/2026

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Directions to “ JERALD COLEMAN ” Practice Location

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