1437108057 NPI number — SHERI HAIN BS, MPAS, PA-C

Table of content: SHERI HAIN BS, MPAS, PA-C (NPI 1437108057)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437108057 NPI number — SHERI HAIN BS, MPAS, PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAIN
Provider First Name:
SHERI
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
BS, MPAS, PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437108057
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/14/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
57 LEBRUN CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GALVESTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77551-1565
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
409-939-5320
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6801 EMMETT F LOWRY EXPY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TEXAS CITY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77591-2500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
409-938-5000
Provider Business Practice Location Address Fax Number:
409-938-5001
Provider Enumeration Date:
05/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  PA03730 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8Y0074 . This is a "BCBSTX PROV. NO." identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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