Provider Demographics
NPI:1831317122
Name:WILCOX, SHARON G
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:G
Last Name:WILCOX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 DODSON ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-6334
Mailing Address - Country:US
Mailing Address - Phone:432-683-1045
Mailing Address - Fax:432-570-4766
Practice Address - Street 1:311 DODSON ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-6334
Practice Address - Country:US
Practice Address - Phone:432-683-1045
Practice Address - Fax:432-570-4766
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management