Provider Demographics
NPI:1376112573
Name:GOLDEN TRIANGLE SURG & VASC ASSOC PLLC
Entity Type:Organization
Organization Name:GOLDEN TRIANGLE SURG & VASC ASSOC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-502-9608
Mailing Address - Street 1:3501 QUEENSBURG LN
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-2227
Mailing Address - Country:US
Mailing Address - Phone:409-502-9608
Mailing Address - Fax:
Practice Address - Street 1:6025 METROPOLITAN DR STE 205
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-2409
Practice Address - Country:US
Practice Address - Phone:409-617-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty