Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | L3820 | TX |
NPI | 1023331360 |
---|---|
Provider Name | Dr. David Paul Sheridan |
First Address | Katy, TX 77450-2140 |
Second Address | Katy, TX 77450-2140 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2010 |
Last Update Date | 01/03/2010 |