Provider Demographics
NPI:1689125429
Name:SHARLA A MAREK PHD PC
Entity Type:Organization
Organization Name:SHARLA A MAREK PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARLA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:MAREK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:719-557-2025
Mailing Address - Street 1:216 N MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-2431
Mailing Address - Country:US
Mailing Address - Phone:281-332-5100
Mailing Address - Fax:281-332-5155
Practice Address - Street 1:216 N MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-2431
Practice Address - Country:US
Practice Address - Phone:281-332-5100
Practice Address - Fax:281-332-5155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-17
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32414103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty