=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790855377
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SHARON J. PIGNOLET, D.C., P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/09/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 206 N DOVE RD
-----------------------------------------------------
City | GRAPEVINE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76051-3105
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-410-2225
-----------------------------------------------------
Fax | 817-251-1509
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 206 N DOVE RD
-----------------------------------------------------
City | GRAPEVINE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76051-3105
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-410-2225
-----------------------------------------------------
Fax | 817-251-1509
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. SHARON J PIGNOLET
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 817-410-2225
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number | 6585
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------