Basic Information
| Provider Information | |||||||||
| NPI: | 1437111952 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHER | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2190 NORTH W LOOP 250 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770188016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134417558 | ||||||||
| FaxNumber: | 7137931594 | ||||||||
| Practice Location | |||||||||
| Address1: | 3120 SOUTHWEST FWY | ||||||||
| Address2: | SUITE 530 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770984509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7136279729 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2006 | ||||||||
| LastUpdateDate: | 09/25/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | H0812 | TX | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 300036980 | 01 | TX | RAILROAD MEDICARE | OTHER | 137738406 | 05 | TX | MEDICAID |