MEDICARE: DAIRA SHERROD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246RP1900X	Phlebotomy Technician

General Provider Information

NPI Number	:	1518787126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAIRA SHERROD

Provider Business Mailing Address
First Line	:	4274 MEDINA RIVER LOOP
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-1543
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	395 SAWDUST RD # 3184
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77380-2242
Country	:	US
Telephone Number	:	346-740-9557
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2024
Last Update Date	:	10/16/2024

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Directions to “ DAIRA SHERROD ” Practice Location

Language	Start Address	Practice Location

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