Individual
SHERYL P. ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CP, LPO
Contact information
Practice address
4110 NORTH ST, NACOGDOCHES, TX 75965-1817
(936) 559-1881
(936) 559-1890
Mailing address
PO BOX 1457, HALLSVILLE, TX 75650-1457
(903) 452-2041
(903) 668-2905
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
46
TX
224P00000X
Prosthetist
Primary
46
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
325159701
—
TX
05
—
325159702
—
TX
01
—
530189
BLUE CROSS & BLUE SHIELD
TX
05
—
806279800
—
ID
Enumeration date
01/18/2007
Last updated
01/18/2021
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