Provider Demographics
NPI:1699059964
Name:SHEERAN, KEVIN PATRICK
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:PATRICK
Last Name:SHEERAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8806 N NAVARRO STE 600 #285
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904
Mailing Address - Country:US
Mailing Address - Phone:361-648-6591
Mailing Address - Fax:361-356-4306
Practice Address - Street 1:106 LANCASTER ST
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-1814
Practice Address - Country:US
Practice Address - Phone:361-648-6591
Practice Address - Fax:361-356-4306
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications