MEDICARE: BERLINDA DENISE WISHOM

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	:	1952238297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERLINDA DENISE WISHOM

Provider Business Mailing Address
First Line	:	11023 WHITE THORN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77016-1882
Country	:	US
Telephone Number	:	281-989-9714
Fax Number	:

Provider Business Practice Location Address
First Line	:	11023 WHITE THORN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77016-1882
Country	:	US
Telephone Number	:	281-989-9714
Fax Number	:

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

Provider Enumeration Date	:	05/08/2026
Last Update Date	:	05/08/2026

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Directions to “ BERLINDA DENISE WISHOM ” Practice Location

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