Healthcare Provider Details

I. General information

NPI: 1114091741
Provider Name (Legal Business Name): SHERIN ELIZABETH WESLEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 01/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 KIRBY ST 109
PEARLAND TX
77584-5704
US

IV. Provider business mailing address

PO BOX 841969
DALLAS TX
75284-1969
US

V. Phone/Fax

Practice location:
  • Phone: 713-512-8600
  • Fax:
Mailing address:
  • Phone: 832-824-2999
  • Fax: 832-825-8900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberM2195
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: