Provider Demographics
NPI:1871688937
Name:SHERRY L. BOWERS, DPM, PA
Entity Type:Organization
Organization Name:SHERRY L. BOWERS, DPM, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:214-335-6032
Mailing Address - Street 1:321 CHERRYTREE LN.
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104
Mailing Address - Country:US
Mailing Address - Phone:972-293-5877
Mailing Address - Fax:972-293-5877
Practice Address - Street 1:321 CHERRYTREE LN
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2984
Practice Address - Country:US
Practice Address - Phone:972-293-5877
Practice Address - Fax:972-293-5877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2008-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1387213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX112182402Medicaid
TX5183600001Medicare NSC
TX8F4935Medicare PIN
TX00X538Medicare PIN
TXU69840Medicare UPIN