Healthcare Provider Details

I. General information

NPI: 1447259668
Provider Name (Legal Business Name): SHERMAN LEE YEAGER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 11/04/2021
Certification Date: 10/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10123 LOUETTA RD STE B200
HOUSTON TX
77070-2160
US

IV. Provider business mailing address

10123 LOUETTA RD STE B200
HOUSTON TX
77070-2160
US

V. Phone/Fax

Practice location:
  • Phone: 832-843-6632
  • Fax: 832-514-6836
Mailing address:
  • Phone: 832-843-6632
  • Fax: 832-514-6836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number8880
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: