BERT E. SHARP, D.P.M., P.A.
Podiatry at 4 St, Longview, TX

License number
Texas 1032
Category
Podiatry
Type
Podiatrist
Owner
Name: DR. BERT EAGLE SHARP DPM
Title: OWNER
Phone: (903) 572-8745
Address
Address
613 N 4Th St, Longview, TX 75601
National Provider ID: 1750504403
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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BERT E. SHARP, D.P.M., PA

613 N 4 St, Longview, TX 75601

Doing business as:
Bert E. Sharp, D.P.M., PA
Registration:
Dec 14, 1994
State ID:
0081577303
Business type:
Professional Association
Director , Member , President:
Bert E. Sharp (Director , Member , President)
Agent:
Bert Eagle Sharp,613 N 4, Longview, TX 75601 (Physical)
TIN:
17525736082

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