Healthcare Provider Details

I. General information

NPI: 1285727339
Provider Name (Legal Business Name): SHARYN KAY HARRIS P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 09/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14100 RANCH ROAD 12 STE 900
WIMBERLEY TX
78676-5354
US

IV. Provider business mailing address

1908 N LAURENT ST STE 370
VICTORIA TX
77901-5468
US

V. Phone/Fax

Practice location:
  • Phone: 512-847-0300
  • Fax: 512-847-0200
Mailing address:
  • Phone: 361-572-0333
  • Fax: 361-572-8518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA00262
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: