Provider Demographics
NPI:1215274337
Name:CARREON, SHERILL ANN PAGDANGANAN (PT)
Entity type:Individual
Prefix:
First Name:SHERILL ANN
Middle Name:PAGDANGANAN
Last Name:CARREON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 E COLLINS ST
Mailing Address - Street 2:
Mailing Address - City:BREMOND
Mailing Address - State:TX
Mailing Address - Zip Code:76629-5247
Mailing Address - Country:US
Mailing Address - Phone:254-742-6495
Mailing Address - Fax:
Practice Address - Street 1:217 E COLLINS ST
Practice Address - Street 2:
Practice Address - City:BREMOND
Practice Address - State:TX
Practice Address - Zip Code:76629-5247
Practice Address - Country:US
Practice Address - Phone:254-742-6495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1205808225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist