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) 572-8745
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
05
—
092750101
—
TX
Enumeration date
04/11/2007
Last updated
02/09/2010
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