Provider Demographics
NPI:1982899019
Name:SHARP-DAVIS, ANGELA (CSA/SA-C)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:
Last Name:SHARP-DAVIS
Suffix:
Gender:F
Credentials:CSA/SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4807 SAN REMO DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-8643
Mailing Address - Country:US
Mailing Address - Phone:817-300-5810
Mailing Address - Fax:
Practice Address - Street 1:4807 SAN REMO DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-8643
Practice Address - Country:US
Practice Address - Phone:817-300-5810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3353246ZC0007X
TX09-197246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other