Provider Demographics
NPI:1467833640
Name:COLE, CHEREKA
Entity Type:Individual
Prefix:
First Name:CHEREKA
Middle Name:
Last Name:COLE
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 1:5050 SUNFLOWER ST APT 148
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77033-3730
Mailing Address - Country:US
Mailing Address - Phone:832-803-9260
Mailing Address - Fax:
Practice Address - Street 1:5050 SUNFLOWER ST APT 148
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77033-3730
Practice Address - Country:US
Practice Address - Phone:832-803-9260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-14
Last Update Date:2015-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker