Provider Demographics
NPI:1245262450
Name:HERR, SYLVIA JEAN (DO)
Entity type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:JEAN
Last Name:HERR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-3845
Mailing Address - Country:US
Mailing Address - Phone:817-645-5904
Mailing Address - Fax:817-645-8764
Practice Address - Street 1:519 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-3845
Practice Address - Country:US
Practice Address - Phone:817-645-5904
Practice Address - Fax:817-645-8764
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3460207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00AY34Medicare ID - Type Unspecified
D97394Medicare UPIN