Provider Demographics
NPI:1225487267
Name:SHERIDAN-NEUMANN, PAMELA (MPH, RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:
Last Name:SHERIDAN-NEUMANN
Suffix:
Gender:F
Credentials:MPH, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12806 KINKAID MEADOWS LN
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-3794
Mailing Address - Country:US
Mailing Address - Phone:781-351-9675
Mailing Address - Fax:
Practice Address - Street 1:12806 KINKAID MEADOWS LN
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-3794
Practice Address - Country:US
Practice Address - Phone:781-351-9675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-09
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT81009133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDT81009OtherTEXAS STATE BOARD OF EXAMINERS OF DIETITIANS