Provider Demographics
NPI:1780687046
Name:DENNIS, SHARON L (DO)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:L
Last Name:DENNIS
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 1:2415 MATLOCK RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-1619
Mailing Address - Country:US
Mailing Address - Phone:817-277-6444
Mailing Address - Fax:817-548-7329
Practice Address - Street 1:2415 MATLOCK RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-1619
Practice Address - Country:US
Practice Address - Phone:817-277-6444
Practice Address - Fax:817-548-7329
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2334207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
86G767Medicare ID - Type Unspecified
D97309Medicare UPIN