Provider Demographics
NPI:1881120129
Name:NUNEZ, SHERRY L (MT125241)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:L
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:MT125241
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:L
Other - Last Name:NUNEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT / COSMETOLOGIST
Mailing Address - Street 1:1928 W 18TH ST # 10
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1275
Mailing Address - Country:US
Mailing Address - Phone:346-837-5992
Mailing Address - Fax:
Practice Address - Street 1:1928 W 18TH ST # 10
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1275
Practice Address - Country:US
Practice Address - Phone:346-837-5992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-05
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82-1365084172M00000X
TXMT125241225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No172M00000XOther Service ProvidersMechanotherapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXMT125241OtherTDLR
TX1747315OtherTDLR- COSMETOLOGIST