Individual
SHERRI L TEN PAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
120 E CHARNWOOD ST, SUITE B, TYLER, TX 75701-1708
(903) 525-1664
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
P7042
TX
207T00000X
Neurological Surgery Physician
2010-01655
NC
207T00000X
Neurological Surgery Physician
P7042
TX
2084N0400X
Neurology Physician
P7042
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00T71U
BCBS BLUE
TX
01
—
2403268
NC MEDICARE PTAN
NC
05
—
322437001
—
TX
05
—
322437002
—
TX
05
—
5915940
—
NC
01
—
75-2616977-026
TRICARE
TX
01
—
752616977001
TRICARE
TX
01
—
752616977002
TRICARE
TX
01
—
752616977015
TRICARE
TX
01
—
752616977028
TRICARE
TX
05
—
NC1289
—
SC
01
—
P01222503
MEDICARE RR
TX
Enumeration date
01/27/2006
Last updated
01/05/2024
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