Provider Demographics
NPI:1619243797
Name:SHEER, CAROL ANN (RD, LD,CDE)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:ANN
Last Name:SHEER
Suffix:
Gender:F
Credentials:RD, LD,CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 E VISTA RIDGE MALL DR
Mailing Address - Street 2:APT 623
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067
Mailing Address - Country:US
Mailing Address - Phone:214-629-0450
Mailing Address - Fax:
Practice Address - Street 1:350 E VISTA RIDGE MALL DR
Practice Address - Street 2:APT 623
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-4072
Practice Address - Country:US
Practice Address - Phone:214-629-0450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-22
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT06915133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01210565OtherMEDICARE RAILROAD