Provider Demographics
NPI:1396042065
Name:BROOKS, TERRI L
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:L
Last Name:BROOKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11802 LOCKWOOD RD TRLR 5
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044-6293
Mailing Address - Country:US
Mailing Address - Phone:281-686-3981
Mailing Address - Fax:
Practice Address - Street 1:11802 LOCKWOOD RD TRLR 5
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77044-6293
Practice Address - Country:US
Practice Address - Phone:281-686-3981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator