Provider Demographics
NPI:1225255698
Name:SHARMA, SANJEEV RAMBLABHAYA (PT)
Entity Type:Individual
Prefix:MR
First Name:SANJEEV
Middle Name:RAMBLABHAYA
Last Name:SHARMA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 S M ST STE 106
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1555
Mailing Address - Country:US
Mailing Address - Phone:956-668-7433
Mailing Address - Fax:
Practice Address - Street 1:2108 S M ST STE 106
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1555
Practice Address - Country:US
Practice Address - Phone:956-668-7433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1143691225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX676624Medicare ID - Type UnspecifiedCLINIC NUMBER