Provider Demographics
NPI:1407837156
Name:STRICKLAND, CAROL A (MD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:A
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 HOLT ST
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-5807
Mailing Address - Country:US
Mailing Address - Phone:713-571-7009
Mailing Address - Fax:713-571-7062
Practice Address - Street 1:1315 ST JOSEPH PKWY STE 1606
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8232
Practice Address - Country:US
Practice Address - Phone:713-571-7009
Practice Address - Fax:713-571-7062
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0293207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXGROUP #155719101Medicaid
F42588Medicare UPIN
00430U/8A1422Medicare ID - Type Unspecified