Healthcare Provider Details

I. General information

NPI: 1831197821
Provider Name (Legal Business Name): HARRY KYLE SHEETS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 03/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 S 1ST ST
MULESHOE TX
79347-3625
US

IV. Provider business mailing address

3004 50TH ST SUITE D
LUBBOCK TX
79413-4129
US

V. Phone/Fax

Practice location:
  • Phone: 806-272-7544
  • Fax: 806-272-5155
Mailing address:
  • Phone: 888-264-0330
  • Fax: 806-368-6936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberK7393
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberK7393
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2001-306
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number04-27778
License Number StateKS
# 5
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD.207870
License Number StateLA
# 6
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number28260
License Number StateOK
# 7
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD0000053504
License Number StateTN
# 8
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number75373
License Number StateGA
# 9
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD.34956
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: