Provider Demographics
NPI:1871356642
Name:SHARPE, TJ (MMP, LMT)
Entity type:Individual
Prefix:
First Name:TJ
Middle Name:
Last Name:SHARPE
Suffix:
Gender:F
Credentials:MMP, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1445 FM 1047
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:TX
Mailing Address - Zip Code:76531
Mailing Address - Country:US
Mailing Address - Phone:254-679-1360
Mailing Address - Fax:
Practice Address - Street 1:1445 FM 1047
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:TX
Practice Address - Zip Code:76531
Practice Address - Country:US
Practice Address - Phone:254-679-1360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT103670225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist