Individual provider Active NPI

Sharon Halliburton

  • Student in an Organized Health Care Education/Training Program
  • Bryan, TX
National Provider Identifier
1982273595
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
40107 Issued in TX
Practice address
725 E Villa Maria Rd Ste 1300
Bryan, TX 77802-5320
Phone
(979) 822-1850
NPI assigned
Jun 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 40107 TX Primary

Addresses

Primary practice location

725 E Villa Maria Rd Ste 1300
Bryan, TX 77802-5320

Mailing address

725 E Villa Maria Rd Ste 1300
Bryan, TX 77802-5320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
40107TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
H-E-B, LP PastSince Jun 22, 2021 Accepting new patients
H-E-B, LP PastSince Jun 22, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1982273595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 E VILLA MARIA RD STE 1300",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 E VILLA MARIA RD STE 1300",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025320",
            "telephone_number": "979-822-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLIBURTON",
        "first_name": "SHARON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-18",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "40107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.