Provider Demographics
NPI:1336475862
Name:LARRY J SHARP DO PA
Entity Type:Organization
Organization Name:LARRY J SHARP DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-246-7676
Mailing Address - Street 1:8509 WESTERN HILLS BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76108-3410
Mailing Address - Country:US
Mailing Address - Phone:817-246-7676
Mailing Address - Fax:817-246-7272
Practice Address - Street 1:8509 WESTERN HILLS BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76108-3410
Practice Address - Country:US
Practice Address - Phone:817-246-7676
Practice Address - Fax:817-246-7272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-18
Last Update Date:2009-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty