Provider Demographics
NPI:1780980086
Name:DOWNEY, SHERRIE LYNN (LMT)
Entity type:Individual
Prefix:
First Name:SHERRIE
Middle Name:LYNN
Last Name:DOWNEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 W 2ND ST
Mailing Address - Street 2:SUITE 154
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102-3021
Mailing Address - Country:US
Mailing Address - Phone:817-999-2543
Mailing Address - Fax:817-392-5874
Practice Address - Street 1:4313 QUAILS LN
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76119-3733
Practice Address - Country:US
Practice Address - Phone:817-999-2543
Practice Address - Fax:817-392-5874
Is Sole Proprietor?:No
Enumeration Date:2011-02-03
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT112341225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist