Provider Demographics
NPI:1467659383
Name:SHARMA, MANJU (MS OTR L)
Entity Type:Individual
Prefix:
First Name:MANJU
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:MS OTR L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7504 BREAKERS LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-3602
Mailing Address - Country:US
Mailing Address - Phone:972-832-8254
Mailing Address - Fax:
Practice Address - Street 1:7504 BREAKERS LN
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-3602
Practice Address - Country:US
Practice Address - Phone:972-832-8254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107662225X00000X
VA0119003099225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist