Provider Demographics
NPI:1740657600
Name:SHERI HATT
Entity type:Organization
Organization Name:SHERI HATT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LPO
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:HATT
Authorized Official - Suffix:
Authorized Official - Credentials:LPO
Authorized Official - Phone:512-412-6322
Mailing Address - Street 1:962 HIGHWAY 71 E
Mailing Address - Street 2:SUITE 3-102
Mailing Address - City:BASTROP
Mailing Address - State:TX
Mailing Address - Zip Code:78602-5023
Mailing Address - Country:US
Mailing Address - Phone:512-412-6322
Mailing Address - Fax:512-651-0349
Practice Address - Street 1:962 HIGHWAY 71 E
Practice Address - Street 2:SUITE 3-102
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-5023
Practice Address - Country:US
Practice Address - Phone:512-412-6322
Practice Address - Fax:512-651-0349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-27
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1557222Z00000X, 224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Multi-Specialty
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Multi-Specialty