Provider Demographics
NPI:1982971446
Name:RICHARDSON, SHERRI DOLL (LMT)
Entity type:Individual
Prefix:MS
First Name:SHERRI
Middle Name:DOLL
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 S CEDAR RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4529
Mailing Address - Country:US
Mailing Address - Phone:972-709-4208
Mailing Address - Fax:972-780-0004
Practice Address - Street 1:204 S CEDAR RIDGE DR
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4529
Practice Address - Country:US
Practice Address - Phone:972-709-4208
Practice Address - Fax:972-780-0004
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT005273174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist