Provider Demographics
NPI:1679899512
Name:YEANG, SHERMAN (RPH)
Entity Type:Individual
Prefix:
First Name:SHERMAN
Middle Name:
Last Name:YEANG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7823 CLOVER KNOLL CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-4174
Mailing Address - Country:US
Mailing Address - Phone:281-463-7739
Mailing Address - Fax:281-463-9165
Practice Address - Street 1:4955 HIGHWAY 6 N
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-2718
Practice Address - Country:US
Practice Address - Phone:281-463-9148
Practice Address - Fax:281-463-9165
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31675183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1275642241OtherPHARMACY NPI
TX465092Medicaid