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General NPI Number Information
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NPI Number | 1629864335
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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 | 1315 ST JOSEPH PKWY STE 1507
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City | HOUSTON
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State | TX
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Zip | 77002-8232
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Country | US
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Telephone | 713-856-5556
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Fax |
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Provider Business Mailing Address
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Address Line | 1315 ST JOSEPH PKWY STE 1507
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City | HOUSTON
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State | TX
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Zip | 77002-8232
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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