Provider Demographics
NPI:1821184011
Name:HORTON, CHERYL JOAN (MD)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:JOAN
Last Name:HORTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1102 HWY 290W
Mailing Address - Street 2:CHERYL HORTON MD
Mailing Address - City:BRENHAM
Mailing Address - State:TX
Mailing Address - Zip Code:77833
Mailing Address - Country:US
Mailing Address - Phone:979-836-9811
Mailing Address - Fax:979-836-1212
Practice Address - Street 1:1102 HWY 290W
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833
Practice Address - Country:US
Practice Address - Phone:979-836-9811
Practice Address - Fax:979-836-1212
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7521207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX031ADOtherBCBS
TX031ADOtherBCBS
B63847Medicare UPIN