Provider Demographics
NPI:1851122139
Name:SHARP, SHELBY (OTR)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:SHARP
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3817 BURKETT DR
Mailing Address - Street 2:
Mailing Address - City:BENBROOK
Mailing Address - State:TX
Mailing Address - Zip Code:76116-1327
Mailing Address - Country:US
Mailing Address - Phone:817-773-0587
Mailing Address - Fax:
Practice Address - Street 1:3817 BURKETT DR
Practice Address - Street 2:
Practice Address - City:BENBROOK
Practice Address - State:TX
Practice Address - Zip Code:76116-1327
Practice Address - Country:US
Practice Address - Phone:817-773-0587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist