Provider Demographics
NPI:1336706019
Name:SUBLETT, SHARETTA KAY (PROVIDER)
Entity Type:Individual
Prefix:
First Name:SHARETTA
Middle Name:KAY
Last Name:SUBLETT
Suffix:
Gender:F
Credentials:PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3604 CHATHAM GREEN LN APT 2034
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-3726
Mailing Address - Country:US
Mailing Address - Phone:682-270-8808
Mailing Address - Fax:
Practice Address - Street 1:3604 CHATHAM GREEN LN APT 2034
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-3726
Practice Address - Country:US
Practice Address - Phone:682-270-8808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-28
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX246YC3301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246YC3301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationCoding Specialist, Hospital Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83-3710661Medicaid