Provider Demographics
NPI:1588914964
Name:PARKER, SHARON ERESSIE (P A)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:ERESSIE
Last Name:PARKER
Suffix:
Gender:F
Credentials:P A
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Other - First Name:
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Mailing Address - Street 1:130 MEDICAL CENTER PKWY
Mailing Address - Street 2:SUITE 7
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-4942
Mailing Address - Country:US
Mailing Address - Phone:936-436-1148
Mailing Address - Fax:936-436-1906
Practice Address - Street 1:130 MEDICAL CENTER PKWY
Practice Address - Street 2:SUITE 7
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-4942
Practice Address - Country:US
Practice Address - Phone:936-436-1148
Practice Address - Fax:936-436-1906
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA01876363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical