Provider Demographics
NPI:1902558158
Name:CORUTHERS, TERRY (PARAMEDIC)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:CORUTHERS
Suffix:
Gender:M
Credentials:PARAMEDIC
Other - Prefix:
Other - First Name:TERRY
Other - Middle Name:
Other - Last Name:CAROTHERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:18734 MONTERO LN
Mailing Address - Street 2:
Mailing Address - City:NEW CANEY
Mailing Address - State:TX
Mailing Address - Zip Code:77357-1770
Mailing Address - Country:US
Mailing Address - Phone:832-229-3943
Mailing Address - Fax:
Practice Address - Street 1:525 N SAM HOUSTON PKWY E STE 360E
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-4030
Practice Address - Country:US
Practice Address - Phone:844-241-0854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX579198146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic