Provider Demographics
NPI:1154209542
Name:ROBERSON, SHEDRICK TORRANCE (RSPS, TOT)
Entity type:Individual
Prefix:
First Name:SHEDRICK
Middle Name:TORRANCE
Last Name:ROBERSON
Suffix:
Gender:M
Credentials:RSPS, TOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13422 COUNTRY PATH WAY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77038-2448
Mailing Address - Country:US
Mailing Address - Phone:832-495-9698
Mailing Address - Fax:
Practice Address - Street 1:13422 COUNTRY PATH WAY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77038-2448
Practice Address - Country:US
Practice Address - Phone:832-495-9698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51384-0125175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty