Provider Demographics
NPI:1255376463
Name:MERIDETH, SHERRI (MD)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:MERIDETH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 CENTRAL EXPY N STE 230
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-6102
Mailing Address - Country:US
Mailing Address - Phone:972-390-1796
Mailing Address - Fax:972-390-1797
Practice Address - Street 1:1105 CENTRAL EXPY N STE 230
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-6102
Practice Address - Country:US
Practice Address - Phone:972-390-1796
Practice Address - Fax:972-390-1797
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71217207V00000X
TXN3178207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB156545Medicare PIN
TXTXB156547Medicare PIN
CAH77514Medicare UPIN
TXTXB156546Medicare PIN