Provider Demographics
NPI:1467762070
Name:MCLEROY, CORINTHIA (MD)
Entity Type:Individual
Prefix:DR
First Name:CORINTHIA
Middle Name:
Last Name:MCLEROY
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 1:5310 GALAXIE RD
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-4502
Mailing Address - Country:US
Mailing Address - Phone:214-221-6362
Mailing Address - Fax:214-345-8784
Practice Address - Street 1:8200 WALNUT HILL LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4426
Practice Address - Country:US
Practice Address - Phone:214-221-6362
Practice Address - Fax:214-345-8784
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP3043207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX307108601Medicaid
TX307108601Medicaid