MEDICARE: DR. SHARON ANNE BAILEY D.O

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
1	207LA0401X	Addiction Medicine (Anesthesiology) Physician	G0654	TX

General Provider Information

NPI Number	:	1730432766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARON ANNE BAILEY D.O

Provider Business Mailing Address
First Line	:	11520 N CENTRAL EXPY
Second Line	:	STE 126
City	:	DALLAS
State	:	TX
Zip	:	75243-6605
Country	:	US
Telephone Number	:	214-396-4844
Fax Number	:	214-341-9997

Provider Business Practice Location Address
First Line	:	11520 N CENTRAL EXPY
Second Line	:	STE 126
City	:	DALLAS
State	:	TX
Zip	:	75243-6605
Country	:	US
Telephone Number	:	214-396-4844
Fax Number	:	214-341-9997

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/15/2012
Last Update Date	:	10/15/2012

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