MEDICARE: SHARICIA D LOVE

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	1744P3200X	Prosthetics Case Management	1955104	TX
2	224P00000X	Prosthetist	1955104	TX

General Provider Information

NPI Number	:	1598627374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARICIA D LOVE

Provider Business Mailing Address
First Line	:	PO BOX 322
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-0109
Country	:	US
Telephone Number	:	469-766-5057
Fax Number	:

Provider Business Practice Location Address
First Line	:	1805 OWEN CT
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-4232
Country	:	US
Telephone Number	:	469-766-5057
Fax Number	:

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

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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Directions to “ SHARICIA D LOVE ” Practice Location

Language	Start Address	Practice Location

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