Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 4079 | TX |
NPI | 1003990599 |
---|---|
Provider Name | Sherry Lee Durrett |
First Address | Houston, TX 77090 |
Second Address | Houston, TX 77090 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 31/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001246001 | (05) | TX |