Provider Demographics
NPI:1215933718
Name:HOUSTON, SHERARD T (MD)
Entity type:Individual
Prefix:DR
First Name:SHERARD
Middle Name:T
Last Name:HOUSTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SHERARD
Other - Middle Name:T
Other - Last Name:HOUSTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1 SAINT FRANCIS DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-3955
Mailing Address - Country:US
Mailing Address - Phone:864-255-1111
Mailing Address - Fax:
Practice Address - Street 1:1 SAINT FRANCIS DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-3955
Practice Address - Country:US
Practice Address - Phone:864-255-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-21
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95946207P00000X
TXQ4981207P00000X
SC023318207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT74283Medicaid
FL275492402Medicaid
FLU8150PMedicare UPIN
SCH61296Medicare UPIN
SC1162Medicare ID - Type UnspecifiedGROUP NUMBER