Provider Demographics
NPI:1538114897
Name:HALE, SHARON KAY (DO)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:KAY
Last Name:HALE
Suffix:
Gender:F
Credentials:DO
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 276
Mailing Address - Street 2:
Mailing Address - City:WORTHAM
Mailing Address - State:TX
Mailing Address - Zip Code:76693-0276
Mailing Address - Country:US
Mailing Address - Phone:254-765-3340
Mailing Address - Fax:254-765-3820
Practice Address - Street 1:618 SOUTH 3RD ST
Practice Address - Street 2:
Practice Address - City:WORTHAM
Practice Address - State:TX
Practice Address - Zip Code:76693
Practice Address - Country:US
Practice Address - Phone:254-765-3340
Practice Address - Fax:254-765-3820
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8W0920OtherBCBS TX
TX8W0920OtherBCBS TX