Provider Demographics
NPI:1982682159
Name:SHERMAN, DENISE IONE (MD)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:IONE
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3888 BRIGHTON CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75707-1675
Mailing Address - Country:US
Mailing Address - Phone:903-565-0303
Mailing Address - Fax:903-565-5446
Practice Address - Street 1:3309 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701
Practice Address - Country:US
Practice Address - Phone:903-565-0303
Practice Address - Fax:903-565-5446
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3463207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F61079Medicare UPIN
8C8104Medicare ID - Type Unspecified