Provider Demographics
NPI:1225451032
Name:DREYER, SHERLENE ANNETTE (MD)
Entity Type:Individual
Prefix:
First Name:SHERLENE
Middle Name:ANNETTE
Last Name:DREYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 MONTROSE BLVD UNIT 19B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-6564
Mailing Address - Country:US
Mailing Address - Phone:713-520-0917
Mailing Address - Fax:
Practice Address - Street 1:5000 MONTROSE BLVD UNIT 19B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-6564
Practice Address - Country:US
Practice Address - Phone:713-520-0917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG93422080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE56310Medicare UPIN