Provider Demographics
NPI:1730390469
Name:SHERMAN, KIM ELIZABETH (OD)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:ELIZABETH
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1209 RANCH CT
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-5463
Mailing Address - Country:US
Mailing Address - Phone:817-281-3822
Mailing Address - Fax:817-503-0562
Practice Address - Street 1:8035 DAVIS BLVD
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180
Practice Address - Country:US
Practice Address - Phone:817-905-6981
Practice Address - Fax:817-503-0562
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4544T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist