Basic Information
| Provider Information | |||||||||
| NPI: | 1841401361 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CEBIK | ||||||||
| FirstName: | SHARON | ||||||||
| MiddleName: | RUTH | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2021 N MACARTHUR BLVD STE 150 | ||||||||
| Address2: | |||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750612210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9722532650 | ||||||||
| FaxNumber: | 9722534218 | ||||||||
| Practice Location | |||||||||
| Address1: | 2021 N MACARTHUR BLVD | ||||||||
| Address2: | SUITE 350 | ||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750612219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9722534265 | ||||||||
| FaxNumber: | 9722534227 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2007 | ||||||||
| LastUpdateDate: | 03/02/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | M7093 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 8J8792 | 01 | TX | MEDICARE PTAN | OTHER | 1907552 01 | 05 | TX | MEDICAID |