Provider Demographics
NPI:1154522209
Name:SHARMA, ANANT (MD)
Entity type:Individual
Prefix:DR
First Name:ANANT
Middle Name:
Last Name:SHARMA
Suffix:
Gender:M
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-2987
Practice Address - Street 1:2900 N I-35 STE 100
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-5142
Practice Address - Country:US
Practice Address - Phone:940-484-5323
Practice Address - Fax:940-323-1190
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200834390200000X, 207R00000X
TXN5393207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX198222502Medicaid
LA1078492Medicaid
LA07849Medicaid
TXP01241044OtherRAILROAD MEDICARE
LA4N423CQ62Medicare PIN
TX291422YKYCMedicare PIN