=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689719338
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTOPHER TIMOTHY SHERMAN MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/20/2007
-----------------------------------------------------
Last Update Date | 02/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4215 JOE RAMSEY BLVD E
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75401-7852
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-408-5000
-----------------------------------------------------
Fax | 903-455-8232
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 501 AIR PARK AVE
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75402-3000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-408-5834
-----------------------------------------------------
Fax | 903-408-5693
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2085R0202X
-----------------------------------------------------
Taxonomy Name | Diagnostic Radiology Physician
-----------------------------------------------------
License Number | L9479
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------