MEDICARE: MRS. ANGELA SHARP-DAVIS CSA/SA-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	246ZC0007X	Surgical Assistant	3353	TX
2	246Z00000X	Other Specialist/Technologist	09-197	TX

General Provider Information

NPI Number	:	1982899019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANGELA SHARP-DAVIS CSA/SA-C

Provider Business Mailing Address
First Line	:	4807 SAN REMO DR
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-8643
Country	:	US
Telephone Number	:	817-300-5810
Fax Number	:

Provider Business Practice Location Address
First Line	:	4807 SAN REMO DR
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-8643
Country	:	US
Telephone Number	:	817-300-5810
Fax Number	:

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

Provider Enumeration Date	:	09/11/2007
Last Update Date	:	06/02/2009

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Directions to “ MRS. ANGELA SHARP-DAVIS CSA/SA-C” Practice Location

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