Provider Demographics
NPI:1073740494
Name:SHARKEY, ANNE MARY (DPM)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MARY
Last Name:SHARKEY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:MARY
Other - Last Name:BREUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:1130 COTTONWOOD CREEK TRL STE B2
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7862
Mailing Address - Country:US
Mailing Address - Phone:512-593-2949
Mailing Address - Fax:512-528-8506
Practice Address - Street 1:1130 COTTONWOOD CREEK TRL BLDG B
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7861
Practice Address - Country:US
Practice Address - Phone:512-593-2949
Practice Address - Fax:512-528-8506
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07001139A213E00000X
390200000X
TX2230213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1073740494Medicaid