Provider Demographics
NPI:1144299819
Name:SHERIFF, THOMAS H (PHD)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:H
Last Name:SHERIFF
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 14
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75151-0014
Mailing Address - Country:US
Mailing Address - Phone:903-874-4656
Mailing Address - Fax:903-874-4666
Practice Address - Street 1:200 N 13TH ST
Practice Address - Street 2:STE 201
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-4618
Practice Address - Country:US
Practice Address - Phone:903-874-4656
Practice Address - Fax:903-874-4666
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21340103T00000X, 103TH0100X, 103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX680010984OtherMEDICARE RAILROAD
TX032148101Medicaid
TX680010984OtherMEDICARE RAILROAD
T15876Medicare UPIN