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Organization
BERT E. SHARP, D.P.M., P.A.
Active
Organization
BERT E. SHARP, D.P.M., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BERT EAGLE SHARP DPM (OWNER)
(903) 757-2300
Entity
Organization
Contact information
Practice address
613 N 4TH ST, LONGVIEW, TX 75601-6616
(903) 757-2300
(903) 758-0279
Mailing address
613 N 4TH ST, LONGVIEW, TX 75601-6616
(903) 757-2300
(903) 758-0279
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1032
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A35L
MEDICARE
TX
05
—
092750102
—
TX
01
—
T15859
UPIN
TX
Enumeration date
02/14/2008
Last updated
01/13/2009
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