Provider Demographics
NPI:1225024227
Name:SHERROD, PETER STEWART (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:STEWART
Last Name:SHERROD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3721 W 15TH ST
Mailing Address - Street 2:STE. 601
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-7755
Mailing Address - Country:US
Mailing Address - Phone:972-596-8100
Mailing Address - Fax:972-867-3658
Practice Address - Street 1:3721 W 15TH ST
Practice Address - Street 2:STE. 601
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7755
Practice Address - Country:US
Practice Address - Phone:972-596-8100
Practice Address - Fax:972-867-3658
Is Sole Proprietor?:No
Enumeration Date:2005-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD6170208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics