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NPI Code Detail

MEDICARE: DR. SHERYL L WILLIS MD

MEDICARE: DR. SHERYL L WILLIS MD
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
1207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianJ5516TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801876636
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHERYL L WILLIS MD
Provider Business Mailing Address
First Line : 14275 MIDWAY RD
Second Line : 400
City : ADDISON
State : TX
Zip : 75001-3614
Country : US
Telephone Number : 214-932-8255
Fax Number : 972-383-2839
Provider Business Practice Location Address
First Line : 401 W CAMPBELL RD
Second Line :
City : RICHARDSON
State : TX
Zip : 75080-3416
Country : US
Telephone Number : 972-498-4724
Fax Number : 972-498-4836
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2006
Last Update Date : 08/27/2010

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