Provider Demographics
NPI:1114677176
Name:STARKS, AERIAL
Entity type:Individual
Prefix:
First Name:AERIAL
Middle Name:
Last Name:STARKS
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 1:21801 NORTHCREST DR APT 1124
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-4062
Mailing Address - Country:US
Mailing Address - Phone:183-280-7105
Mailing Address - Fax:
Practice Address - Street 1:3724 FM 1960 RD W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068-3528
Practice Address - Country:US
Practice Address - Phone:346-372-0771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator