Provider Demographics
NPI:1952628661
Name:MASTERSON, SHERRY LYNNETTE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:LYNNETTE
Last Name:MASTERSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6161 N STATE HIGHWAY 161
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-2220
Mailing Address - Country:US
Mailing Address - Phone:972-257-7499
Mailing Address - Fax:214-257-0897
Practice Address - Street 1:6161 N HIGHWAY 161
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038
Practice Address - Country:US
Practice Address - Phone:972-258-7499
Practice Address - Fax:972-257-0897
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06347363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical