Provider Demographics
NPI:1942538327
Name:MAYO, SHERI L (PA-C)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:L
Last Name:MAYO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4214 ANDREWS HWY STE 240
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79703-4817
Mailing Address - Country:US
Mailing Address - Phone:432-686-6605
Mailing Address - Fax:432-682-2284
Practice Address - Street 1:1805 S COUNTY RD 1105
Practice Address - Street 2:STE D & E
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79706-5120
Practice Address - Country:US
Practice Address - Phone:432-221-1325
Practice Address - Fax:432-221-1324
Is Sole Proprietor?:No
Enumeration Date:2009-11-24
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX079837301Medicaid