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General NPI Number Information
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NPI Number | 1619763331
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Entity Type | Organization
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Legal Business Name | SHERMAN MD PROVIDER INC
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Dates
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Enumeration Date | 04/18/2025
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 2555 JIMMY JOHNSON BLVD STE 500
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City | PORT ARTHUR
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State | TX
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Zip | 77640-2007
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Country | US
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Telephone | 409-853-5144
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Fax |
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Provider Business Mailing Address
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Address Line | 2555 JIMMY JOHNSON BLVD STE 500
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City | PORT ARTHUR
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State | TX
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Zip | 77640-2007
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CCO
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Name | JONATHAN BURKET
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Credential |
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Telephone | 818-666-0602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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