Basic Information
Provider Information
NPI: 1992730071
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHERMAN
FirstName: PAMELA
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SHERMAN-BROWNE
OtherFirstName: PAMELA
OtherMiddleName: J
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 733784
Address2:  
City: DALLAS
State: TX
PostalCode: 753733784
CountryCode: US
TelephoneNumber: 6828851855
FaxNumber: 6828851396
Practice Location
Address1: 1500 COOPER ST
Address2:  
City: FORT WORTH
State: TX
PostalCode: 761042710
CountryCode: US
TelephoneNumber: 6828854405
FaxNumber: 6828854407
Other Information
ProviderEnumerationDate: 07/11/2006
LastUpdateDate: 06/01/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/01/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207XP3100XM9002TXN Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
207X00000X0101235395VAN Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207XS0106XM9002TXY Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery

No ID Information.


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