MEDICARE: MRS. SHARON KAY BERNARDEZ PA-C

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	363A00000X	Physician Assistant	PA00213	TX

General Provider Information

NPI Number	:	1851699763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHARON KAY BERNARDEZ PA-C

Provider Business Mailing Address
First Line	:	3750 S UNIVERSITY DR
Second Line	:	SUITE 202
City	:	FORT WORTH
State	:	TX
Zip	:	76109-3795
Country	:	US
Telephone Number	:	817-924-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3750 S UNIVERSITY DR
Second Line	:	SUITE 202
City	:	FORT WORTH
State	:	TX
Zip	:	76109-3795
Country	:	US
Telephone Number	:	817-924-1000
Fax Number	:

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

Provider Enumeration Date	:	03/02/2011
Last Update Date	:	03/02/2011

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