Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 21340 | TX |
Y | 103T00000X | Psychologist | 21340 | TX |
N | 103TH0100X | Health Service | 21340 | TX |
N | 103TR0400X | Rehabilitation Psychologist | 21340 | TX |
NPI | 1144299819 |
---|---|
Provider Name | Mr. Thomas H Sheriff |
First Address | Corsicana, TX 75151-0014 |
Second Address | Corsicana, TX 75110-4618 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2006 |
Last Update Date | 26/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
032148101 | (05) | TX |
680010984 | MEDICARE RAILROAD (01) | TX |
T15876 | (02) |