Provider Demographics
NPI:1962475822
Name:SHARMA, VIJAY K (MD)
Entity Type:Individual
Prefix:
First Name:VIJAY
Middle Name:K
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:VIJAY
Other - Middle Name:K
Other - Last Name:SHARMA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5140 LEGENDARY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-9042
Mailing Address - Country:US
Mailing Address - Phone:972-867-9507
Mailing Address - Fax:972-578-7705
Practice Address - Street 1:5140 LEGENDARY DR STE 100
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-9042
Practice Address - Country:US
Practice Address - Phone:972-867-9507
Practice Address - Fax:972-578-7705
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1927207R00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8153B6Medicare ID - Type Unspecified
TXG14228Medicare UPIN