Provider Demographics
NPI:1154965739
Name:STERLING RIDGE ORTHOPAEDICS AND SPORTS MEDICINE, LLC
Entity type:Organization
Organization Name:STERLING RIDGE ORTHOPAEDICS AND SPORTS MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-364-1122
Mailing Address - Street 1:20639 KUYKENDAHL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-3587
Mailing Address - Country:US
Mailing Address - Phone:832-698-0111
Mailing Address - Fax:
Practice Address - Street 1:20639 KUYKENDAHL RD STE 200
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-3587
Practice Address - Country:US
Practice Address - Phone:832-698-0111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STERLING RIDGE ORTHOPAEDICS AND SPORTS MEDICINE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-11-06
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Single Specialty