Provider Demographics
NPI:1467932624
Name:PALMER, SHARANDA IRENE (TRICHOLOGIST)
Entity Type:Individual
Prefix:
First Name:SHARANDA
Middle Name:IRENE
Last Name:PALMER
Suffix:
Gender:F
Credentials:TRICHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4433 PUNJAB WAY STE 402
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-6747
Mailing Address - Country:US
Mailing Address - Phone:214-973-6314
Mailing Address - Fax:
Practice Address - Street 1:4433 PUNJAB WAY STE 402
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-6747
Practice Address - Country:US
Practice Address - Phone:614-687-8102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-17
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1864986174400000X
1744P3200X, 332B00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialist
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies