Provider Demographics
NPI:1144552357
Name:SHERWOOD, STEVEN RAY (RPH)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:RAY
Last Name:SHERWOOD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:301 HWY 110 N
Mailing Address - Street 2:PO BOX 1310
Mailing Address - City:WHITEHOUSE
Mailing Address - State:TX
Mailing Address - Zip Code:75791-3111
Mailing Address - Country:US
Mailing Address - Phone:903-839-4391
Mailing Address - Fax:903-839-6365
Practice Address - Street 1:104 W HENDERSON ST
Practice Address - Street 2:
Practice Address - City:OVERTON
Practice Address - State:TX
Practice Address - Zip Code:75684
Practice Address - Country:US
Practice Address - Phone:903-834-0154
Practice Address - Fax:903-834-0156
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28412183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist