MEDICARE: SHARON R SANDELL MD

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	2080P0203X	Pediatric Critical Care Medicine Physician	H4673	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8836M4	OTHER	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821092446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON R SANDELL MD

Provider Business Mailing Address
First Line	:	PO BOX 515055
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75251-5055
Country	:	US
Telephone Number	:	972-566-8340
Fax Number	:	972-566-8338

Provider Business Practice Location Address
First Line	:	7777 FOREST LN
Second Line	:	D569
City	:	DALLAS
State	:	TX
Zip	:	75230-2505
Country	:	US
Telephone Number	:	972-566-8340
Fax Number	:	972-566-8338

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

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	08/21/2009

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Directions to “ SHARON R SANDELL MD” Practice Location

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