MEDICARE: MS. SHARON NOEL SLUBAR DAVIS 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	363AS0400X	Surgical Physician Assistant	PA03989	TX

General Provider Information

NPI Number	:	1508862764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHARON NOEL SLUBAR DAVIS PA-C

Provider Business Mailing Address
First Line	:	PO BOX 67000
Second Line	:	SUITE 325
City	:	DETROIT
State	:	MI
Zip	:	48267-2728
Country	:	US
Telephone Number	:	210-615-7700
Fax Number	:	210-615-1782

Provider Business Practice Location Address
First Line	:	4330 MEDICAL DR
Second Line	:	SUITE 325
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3342
Country	:	US
Telephone Number	:	210-615-7700
Fax Number	:	210-615-1782

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	11/28/2016

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