Basic Information
| Provider Information | |||||||||
| NPI: | 1851512826 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOOD | ||||||||
| FirstName: | CHERYL | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4603 STEVENS RD | ||||||||
| Address2: | |||||||||
| City: | MANVEL | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775784553 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814137630 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6550 FANNIN ST | ||||||||
| Address2: | SUITE 1101 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770302717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134410006 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2007 | ||||||||
| LastUpdateDate: | 08/13/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA 02295 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | 304732602 | 05 | TX | MEDICAID | 8313NH | 01 | TX | BLUE CROSS BLUE SHIELD | OTHER | P01170500 | 01 | TX | RR MEDICARE | OTHER | 304732601 | 05 | TX | MEDICAID | 1851512826 | 01 | TX | BLUE CROSS BLUE SHIELD | OTHER | 878N59 | 01 | TX | BLUE CROSS BLUE SHIELD | OTHER |