Healthcare Provider Details

I. General information

NPI: 1770887374
Provider Name (Legal Business Name): SCOTT R. SHERRON, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2010
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6624 FANNIN ST STE 1995
HOUSTON TX
77030-2312
US

IV. Provider business mailing address

6624 FANNIN ST STE 1995
HOUSTON TX
77030-2312
US

V. Phone/Fax

Practice location:
  • Phone: 713-800-9026
  • Fax: 713-930-4220
Mailing address:
  • Phone: 713-800-9026
  • Fax: 713-930-4220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY SUSY SHERRON
Title or Position: PRACTICE MANAGER
Credential:
Phone: 713-213-1923