Provider Demographics
NPI:1346745692
Name:SHARYLAND FAMILY MEDICAL CLINIC PLLC
Entity Type:Organization
Organization Name:SHARYLAND FAMILY MEDICAL CLINIC PLLC
Other - Org Name:SHARYLAND FAMILY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:KINDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-581-2763
Mailing Address - Street 1:2304 NICOLE DR
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78574-9716
Mailing Address - Country:US
Mailing Address - Phone:956-703-6421
Mailing Address - Fax:956-581-9962
Practice Address - Street 1:2118 E GRIFFIN PKWY
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-3225
Practice Address - Country:US
Practice Address - Phone:956-581-2763
Practice Address - Fax:956-581-9962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-28
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty