Provider Demographics
NPI:1588642722
Name:SHARP, LARRY E (MD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:E
Last Name:SHARP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5410 MARYLAND WAY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5064
Mailing Address - Country:US
Mailing Address - Phone:615-377-5652
Mailing Address - Fax:949-567-9827
Practice Address - Street 1:1600 11TH ST
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-4300
Practice Address - Country:US
Practice Address - Phone:940-764-3983
Practice Address - Fax:940-764-3978
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2008-12-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXG5600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8X9801OtherBCBS
TX123208405Medicaid
TXP00471685Medicare PIN
TX8J4636Medicare PIN