Provider Demographics
NPI:1336155498
Name:WILKS, SHARON T (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:T
Last Name:WILKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 91130
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-2987
Practice Address - Street 1:2130 N.E.LOOP 410
Practice Address - Street 2:SUITE #100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-4660
Practice Address - Country:US
Practice Address - Phone:210-637-0641
Practice Address - Fax:210-656-3687
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5027207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2047139OtherAETNA HMO
TX83791JOtherBLUECROSS/BLUESHIELD TX.
TXP01547638OtherRAILROAD MEDICARE
TX042234701Medicaid
TX042234703Medicaid
TX5589618OtherAETNA PPO
TX2047139OtherAETNA HMO
TX438202YKYCMedicare PIN
TX83791JOtherBLUECROSS/BLUESHIELD TX.
TX042234701Medicaid