Healthcare Provider Details
I. General information
NPI: 1841696846
Provider Name (Legal Business Name): SHERMAN MD PROVIDER INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/18/2014
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 N HIGHLAND AVE
SHERMAN TX
75092-7354
US
IV. Provider business mailing address
1908 N LAURENT ST STE 330
VICTORIA TX
77901-5467
US
V. Phone/Fax
- Phone: 903-870-4611
- Fax:
- Phone: 361-572-0333
- Fax: 361-572-8518
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
J
SARRAO
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 361-572-0333