Provider Demographics
NPI:1255578308
Name:STERLING IMAGING INC.
Entity type:Organization
Organization Name:STERLING IMAGING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:BAXTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-640-7834
Mailing Address - Street 1:33840 S. GARCIA #20
Mailing Address - Street 2:
Mailing Address - City:PORT ISABEL
Mailing Address - State:TX
Mailing Address - Zip Code:78578
Mailing Address - Country:US
Mailing Address - Phone:832-640-7834
Mailing Address - Fax:866-222-0783
Practice Address - Street 1:33840 S. GARCIA #20
Practice Address - Street 2:
Practice Address - City:PORT ISABEL
Practice Address - State:TX
Practice Address - Zip Code:78578
Practice Address - Country:US
Practice Address - Phone:832-640-7834
Practice Address - Fax:866-222-0783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC2793TX261QR0400X, 261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherBLUE CROSS BLUE SHEILD
TX=========OtherZURICH
TX=========Medicare PIN
TX=========OtherZURICH