Basic Information
Provider Information
NPI: 1134539703
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STERLING
FirstName: GARRETT
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.S., CCC-SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 305 NE LOOP 820
Address2: SUITE 200
City: HURST
State: TX
PostalCode: 760537209
CountryCode: US
TelephoneNumber: 8172928787
FaxNumber: 8177896849
Practice Location
Address1: 3120 SOUTHWEST FWY
Address2: SUITE 612
City: HOUSTON
State: TX
PostalCode: 770984509
CountryCode: US
TelephoneNumber: 7139793800
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/05/2014
LastUpdateDate: 05/05/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X108559TXY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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