Provider Demographics
NPI:1588653406
Name:SHARMA, JIVESH J (MD)
Entity Type:Individual
Prefix:
First Name:JIVESH
Middle Name:J
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 FOREST LN STE B242
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2525
Mailing Address - Country:US
Mailing Address - Phone:214-739-1706
Mailing Address - Fax:214-368-1611
Practice Address - Street 1:7777 FOREST LN STE B242
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2525
Practice Address - Country:US
Practice Address - Phone:214-739-1706
Practice Address - Fax:214-368-1611
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5488207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137046210Medicaid
TX137046208Medicaid
TX86551NMedicare PIN
TX137046210Medicaid
TX137046208Medicaid
TX83001153Medicare PIN
TXTXB141466Medicare PIN