Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ||
N | 222Z00000X | Podiatrist | ||
Y | 224P00000X | Prosthetist |
NPI | 1376940924 |
---|---|
Provider Name | Mr. James W Sherrill III |
First Address | Houston, TX 77025-5600 |
Second Address | Houston, TX 77025-5600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2014 |
Last Update Date | 25/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CPO3003 | AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS AND PROSTHETICS (01) | |
LPO 1419 | TEXAS BOARD OF ORTHOTICS AND PROSTHETICS (01) | TX |