Provider Demographics
NPI:1215171913
Name:TAFT, SHARRONE HILL (PA)
Entity type:Individual
Prefix:
First Name:SHARRONE
Middle Name:HILL
Last Name:TAFT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 REGIONAL MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:WHARTON
Mailing Address - State:TX
Mailing Address - Zip Code:77488-9719
Mailing Address - Country:US
Mailing Address - Phone:979-532-1700
Mailing Address - Fax:979-532-6792
Practice Address - Street 1:2100 REGIONAL MEDICAL DR
Practice Address - Street 2:
Practice Address - City:WHARTON
Practice Address - State:TX
Practice Address - Zip Code:77488-9719
Practice Address - Country:US
Practice Address - Phone:979-532-1700
Practice Address - Fax:979-532-6792
Is Sole Proprietor?:No
Enumeration Date:2009-04-24
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA01702363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00716390OtherTRAVERLERS RAILROAD MEDICARE
TXP01090545OtherRAILROAD MEDICARE PTAN
TX875N34OtherBC/BS #
TX8Y9928OtherBCBS OF TEXAS
TX306198804Medicaid
TXP01090545OtherRAILROAD MEDICARE PTAN
TX306198804Medicaid