Provider Demographics
NPI:1245754381
Name:GAMBLE KING, SHARON DENISE
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:DENISE
Last Name:GAMBLE KING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7412 LAKE JUNE RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75217-1644
Mailing Address - Country:US
Mailing Address - Phone:214-779-3998
Mailing Address - Fax:
Practice Address - Street 1:7412 LAKE JUNE RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75217-1644
Practice Address - Country:US
Practice Address - Phone:214-779-3998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-31
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No376K00000XNursing Service Related ProvidersNurse's Aide