Provider Demographics
NPI:1376731695
Name:SHERROD, SUE ANN (MD)
Entity type:Individual
Prefix:DR
First Name:SUE
Middle Name:ANN
Last Name:SHERROD
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4925 SUGAR MILL RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-6935
Mailing Address - Country:US
Mailing Address - Phone:214-906-9036
Mailing Address - Fax:972-490-7350
Practice Address - Street 1:4925 SUGAR MILL RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-6935
Practice Address - Country:US
Practice Address - Phone:214-906-9036
Practice Address - Fax:972-490-7350
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXD65402084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC21748Medicare UPIN