Provider Demographics
NPI:1467465849
Name:ACOSTA, SHARRON KATHERINE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARRON
Middle Name:KATHERINE
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 E COURT ST
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-5813
Mailing Address - Country:US
Mailing Address - Phone:830-379-3937
Mailing Address - Fax:
Practice Address - Street 1:908 E COURT ST
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-5813
Practice Address - Country:US
Practice Address - Phone:830-379-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2307207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX046168302Medicaid
TX046168302Medicaid
TX046168302Medicaid
TX180041725Medicare ID - Type UnspecifiedRAILROAD