Provider Demographics
NPI:1356640205
Name:HATT, SHERI (LPO, BOCPO)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:
Last Name:HATT
Suffix:
Gender:F
Credentials:LPO, BOCPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:962 HIGHWAY 71 EAST
Mailing Address - Street 2:STE 3-102
Mailing Address - City:BASTROP
Mailing Address - State:TX
Mailing Address - Zip Code:78602-5023
Mailing Address - Country:US
Mailing Address - Phone:512-412-6322
Mailing Address - Fax:512-651-0349
Practice Address - Street 1:962 HIGHWAY 71 EAST
Practice Address - Street 2:STE. 3-102
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602
Practice Address - Country:US
Practice Address - Phone:512-412-6322
Practice Address - Fax:512-651-0349
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-17
Last Update Date:2020-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX347013001Medicaid