Provider Demographics
NPI:1093033698
Name:SHARRON, JENNIFER A (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:A
Last Name:SHARRON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:11212 STATE HIGHWAY 151
Mailing Address - Street 2:PLAZA 1, SUITE 200
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4498
Mailing Address - Country:US
Mailing Address - Phone:210-520-7160
Mailing Address - Fax:210-520-7190
Practice Address - Street 1:11212 STATE HIGHWAY 151
Practice Address - Street 2:PLAZA 1, SUITE 200
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4498
Practice Address - Country:US
Practice Address - Phone:210-520-7160
Practice Address - Fax:210-520-7190
Is Sole Proprietor?:No
Enumeration Date:2010-05-07
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXQ19072084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX357523501Medicaid
TX375561ZKK7Medicare PIN