Provider Demographics
NPI:1386496867
Name:POINDEXTER, SHARON (COSMETOLOGIST)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:
Last Name:POINDEXTER
Suffix:
Gender:F
Credentials:COSMETOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 JUSTIN RD STE 201 #5132
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077
Mailing Address - Country:US
Mailing Address - Phone:469-674-9649
Mailing Address - Fax:214-838-8124
Practice Address - Street 1:1301 JUSTIN RD STE 201 #5132
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75077
Practice Address - Country:US
Practice Address - Phone:469-674-9649
Practice Address - Fax:214-838-8124
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier