Provider Demographics
NPI:1073638490
Name:SHARRON ACOSTA M.D.P.A.
Entity Type:Organization
Organization Name:SHARRON ACOSTA M.D.P.A.
Other - Org Name:EYE ASSOCIATES OF SOUTH TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-379-9600
Mailing Address - Street 1:PO BOX 202293
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-2293
Mailing Address - Country:US
Mailing Address - Phone:830-379-9600
Mailing Address - Fax:830-303-2222
Practice Address - Street 1:908 E COURT ST
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-5813
Practice Address - Country:US
Practice Address - Phone:830-379-3937
Practice Address - Fax:830-379-2021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2307207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX180043813OtherMEDICARE RAILROAD
TX141567101Medicaid
TX180041725OtherMEDICARE RAILROAD
TX8386M0Medicare ID - Type Unspecified
TX141567101Medicaid