MEDICARE: TOM F. SHERIFF, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	3216TG	TX

General Provider Information

NPI Number	:	1316113079
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOM F. SHERIFF, P.A.

Provider Business Mailing Address
First Line	:	4206 KEMP BLVD
Second Line	:	SUITE B
City	:	WICHITA FALLS
State	:	TX
Zip	:	76308-2846
Country	:	US
Telephone Number	:	940-696-2653
Fax Number	:	940-696-2685

Provider Business Practice Location Address
First Line	:	4206 KEMP BLVD
Second Line	:	SUITE B
City	:	WICHITA FALLS
State	:	TX
Zip	:	76308-2846
Country	:	US
Telephone Number	:	940-696-2653
Fax Number	:	940-696-2685

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. THOMAS FILMORE SHERIFF
Credential	:	O.D.
Telephone Number	:	940-696-3409

Provider Enumeration Date	:	05/02/2008
Last Update Date	:	05/02/2008

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