Provider Demographics
NPI:1821028267
Name:SHERMAN, VADIM (MD)
Entity Type:Individual
Prefix:
First Name:VADIM
Middle Name:
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:SUITE 1601
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-441-5141
Mailing Address - Fax:
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SUITE 1601
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-441-5141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41407208600000X
TXM6393208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX182083903Medicaid
TXP01061315OtherRR MEDICARE
TX8AC478OtherBCBS
TX8CL382OtherBCBS
TX182083901Medicaid
TX182083902Medicaid
TX182083904Medicaid
TX1821028267OtherBLUE CROSS BLUE SHIELD
TX8DY890OtherBLUE CROSS BLUE SHIELD
TXP00993704OtherRR MEDICARE
TX541204ZSWDMedicare PIN
TXP00993704OtherRR MEDICARE
TX8AC478OtherBCBS
TX182083902Medicaid
TXTXB109229Medicare PIN