Provider Demographics
NPI:1700045762
Name:AMBREEN SHARAF, MD PA
Entity Type:Organization
Organization Name:AMBREEN SHARAF, MD PA
Other - Org Name:ELITE MEDICAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMBREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARAF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-342-4000
Mailing Address - Street 1:17510 W GRAND PKWY S
Mailing Address - Street 2:SUITE 540
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2645
Mailing Address - Country:US
Mailing Address - Phone:281-342-4000
Mailing Address - Fax:281-232-8880
Practice Address - Street 1:17510 W GRAND PKWY
Practice Address - Street 2:SUITE 540
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2645
Practice Address - Country:US
Practice Address - Phone:281-342-4000
Practice Address - Fax:281-232-8880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4941207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Z414OtherMEDICARE PTAN
TX8BM000OtherBLUE CROSS BLUE SHIELD