Healthcare Provider Details

I. General information

NPI: 1659315034
Provider Name (Legal Business Name): SHERMAN GRAYSON HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 02/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N HIGHLAND
SHERMAN TX
75092
US

IV. Provider business mailing address

119 W HOUSTON ST
SHERMAN TX
75090-5909
US

V. Phone/Fax

Practice location:
  • Phone: 903-870-4611
  • Fax: 903-891-2030
Mailing address:
  • Phone: 903-891-7000
  • Fax: 903-813-1479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: MR. VANCE VERNON REYNOLDS
Title or Position: PRESIDENT & CHIEF EXECUTIVE OFFICER
Credential:
Phone: 903-870-4591