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NPI Code Detail

MEDICARE: SHARONDA TIPTON

MEDICARE:   SHARONDA  TIPTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist121771TX

General Provider Information

NPI Number : 1235503293
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHARONDA TIPTON
Provider Business Mailing Address
First Line : 4321 LOMBARDY DR
Second Line :
City : VENUS
State : TX
Zip : 76084-3654
Country : US
Telephone Number : 317-236-8557
Fax Number :
Provider Business Practice Location Address
First Line : 605 E BROAD ST
Second Line :
City : MANSFIELD
State : TX
Zip : 76063-1794
Country : US
Telephone Number : 317-236-8557
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2015
Last Update Date : 04/10/2026

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Directions to “ SHARONDA TIPTON ” Practice Location

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