Provider Demographics
NPI:1801959994
Name:FRIERSON, SHERYL L (MD)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:L
Last Name:FRIERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHERYL
Other - Middle Name:
Other - Last Name:RIMRODT-FRIERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2222 WELBORN ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-3924
Mailing Address - Country:US
Mailing Address - Phone:214-559-5000
Mailing Address - Fax:
Practice Address - Street 1:2222 WELBORN ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-3924
Practice Address - Country:US
Practice Address - Phone:214-559-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD453242080P0008X, 2080P0008X
TXS29812080P0008X
MDD00604762080P0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0008XAllopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD408030100Medicaid
MD64625201OtherCAREFIRST BC BS
MDK631L780Medicare ID - Type Unspecified
MD408030100Medicaid