Provider Demographics
NPI:1437197365
Name:BALEY, SHARON L (CNS)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:L
Last Name:BALEY
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-0813
Practice Address - Street 1:901 W 38TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1165
Practice Address - Country:US
Practice Address - Phone:512-419-9733
Practice Address - Fax:512-451-3709
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX431090364SX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX195990002Medicaid
TX195990003Medicaid
TX195990001Medicaid
TX195990003Medicaid
TX8L25005Medicare PIN
TX8L1754Medicare PIN
TX195990001Medicaid
TX8L1753Medicare PIN