Healthcare Provider Details

I. General information

NPI: 1417342874
Provider Name (Legal Business Name): SHEEBA K CHERIAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2015
Last Update Date: 05/03/2022
Certification Date: 05/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 FOREST LN STE B332
DALLAS TX
75230-6822
US

IV. Provider business mailing address

DEPT. 453 PO BOX 1000
MEMPHIS TN
38148-0001
US

V. Phone/Fax

Practice location:
  • Phone: 972-566-7788
  • Fax: 972-566-8837
Mailing address:
  • Phone: 828-575-2625
  • Fax: 828-350-2174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberS4929
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: