Provider Demographics
NPI:1003967274
Name:GILLETTE, SHEILA ODOM
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:ODOM
Last Name:GILLETTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:ODOM
Other - Last Name:GILLETTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:22907 NORTHAMPTON PINES DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77389-5006
Mailing Address - Country:US
Mailing Address - Phone:281-639-4217
Mailing Address - Fax:281-586-0706
Practice Address - Street 1:17070 RED OAK DR
Practice Address - Street 2:STE 103
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2619
Practice Address - Country:US
Practice Address - Phone:281-586-0771
Practice Address - Fax:281-586-0706
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25299183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist