MEDICARE: PAUL CLETUS SHARKEY JR. 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	2080P0214X	Pediatric Pulmonology Physician	H9268	TX
2	207K00000X	Allergy & Immunology Physician	H9268	TX

General Provider Information

NPI Number	:	1912989690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL CLETUS SHARKEY JR. MD

Provider Business Mailing Address
First Line	:	1000 E FIFTH ST
Second Line	:	STE 200
City	:	DALLAS
State	:	TX
Zip	:	75373-1912
Country	:	US
Telephone Number	:	903-747-9600
Fax Number	:	903-747-9601

Provider Business Practice Location Address
First Line	:	1000 E FIFTH ST
Second Line	:	STE 200
City	:	DALLAS
State	:	TX
Zip	:	75373-1912
Country	:	US
Telephone Number	:	903-747-9600
Fax Number	:	903-747-9601

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

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	02/24/2026

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