Provider Demographics
NPI:1720151368
Name:BHARGAVA, SHARLAW (MD)
Entity Type:Individual
Prefix:
First Name:SHARLAW
Middle Name:
Last Name:BHARGAVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O BOX 1135,
Mailing Address - Street 2:102 E BROADWAY STREET
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-9998
Mailing Address - Country:US
Mailing Address - Phone:214-727-8187
Mailing Address - Fax:972-347-5450
Practice Address - Street 1:831 AMISTAD DR
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-8427
Practice Address - Country:US
Practice Address - Phone:214-727-8187
Practice Address - Fax:972-347-5450
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM10242084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F1819Medicare ID - Type Unspecified
TXI46408Medicare UPIN