Provider Demographics
NPI:1689232100
Name:SHERIFF, HADJI MOHAMED (DC)
Entity Type:Individual
Prefix:
First Name:HADJI
Middle Name:MOHAMED
Last Name:SHERIFF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 N JUPITER RD STE 110
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-3243
Mailing Address - Country:US
Mailing Address - Phone:469-330-2225
Mailing Address - Fax:972-238-1924
Practice Address - Street 1:901 N JUPITER RD STE 110
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-3243
Practice Address - Country:US
Practice Address - Phone:469-330-2225
Practice Address - Fax:972-238-1924
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14103111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX14103OtherLICENSE