Provider Demographics
NPI:1366758823
Name:COREAS, ERICA T (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:T
Last Name:COREAS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11049 MEMORIAL HERMANN DR STE 200
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3307
Mailing Address - Country:US
Mailing Address - Phone:713-486-6000
Mailing Address - Fax:
Practice Address - Street 1:11049 MEMORIAL HERMANN DR STE 200
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-3307
Practice Address - Country:US
Practice Address - Phone:713-486-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-23
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1055013363L00000X
246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty