Provider Demographics
NPI:1982647806
Name:GREGORCYK, SHARON G (MD)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:G
Last Name:GREGORCYK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:11551 FOREST CENTRAL DR
Mailing Address - Street 2:STE 133
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3920
Mailing Address - Country:US
Mailing Address - Phone:214-343-8565
Mailing Address - Fax:214-342-3054
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:A-321
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2505
Practice Address - Country:US
Practice Address - Phone:972-661-3575
Practice Address - Fax:972-233-9120
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2021-03-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK7546208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175424402Medicaid
TX175424401Medicaid
TX175424401Medicaid