Sherri Gilliard

Individual provider Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Waller, TX

NPI 1306265160 · NPPES record last updated Apr 9, 2014

Key facts

NPI
1306265160
Entity type
Individual (NPI type 1)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Practice address
16107 FM 362 Rd
Waller, TX 77484-9369
Phone
(936) 524-7757
Fax
(281) 251-0577
NPI assigned
Apr 9, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Yes

Addresses

Primary practice location

16107 FM 362 Rd
Waller, TX 77484-9369

Mailing address

PO Box 2146
Prairie View, TX 77446-2146
Phone (936) 524-7757

Other providers in Waller, TX

All providers in Waller, TX · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Texas

Sources for this page

Verify at the official NPI Registry.