Provider Demographics
NPI:1104819432
Name:ALLAN M SHERMAN DPM PC
Entity type:Organization
Organization Name:ALLAN M SHERMAN DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PODIATRIST
Authorized Official - Phone:972-233-4351
Mailing Address - Street 1:6310 LBJ FWY
Mailing Address - Street 2:SUITE 117
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-6401
Mailing Address - Country:US
Mailing Address - Phone:972-233-4351
Mailing Address - Fax:972-233-0359
Practice Address - Street 1:6310 LBJ FWY
Practice Address - Street 2:SUITE 117
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6401
Practice Address - Country:US
Practice Address - Phone:972-233-4351
Practice Address - Fax:972-233-0359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX513213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T15877Medicare UPIN
TX00T397Medicare PIN