Provider Demographics
NPI:1538261565
Name:MARTINI, SHARON RAE (MD)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:RAE
Last Name:MARTINI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 OAKWELL FARMS PKWY
Mailing Address - Street 2:STE 230
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218
Mailing Address - Country:US
Mailing Address - Phone:210-822-4969
Mailing Address - Fax:210-822-4919
Practice Address - Street 1:1919 OAKWELL FARMS PKWY
Practice Address - Street 2:STE 230
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218
Practice Address - Country:US
Practice Address - Phone:210-822-4969
Practice Address - Fax:210-822-4919
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK27472084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX044111503Medicaid
00060QMedicare ID - Type Unspecified
H25151Medicare UPIN