Provider Demographics
NPI:1043801541
Name:WHITE, SHELBY (CPHT)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11100 FM 1960 APT 1427
Mailing Address - Street 2:
Mailing Address - City:HUFFMAN
Mailing Address - State:TX
Mailing Address - Zip Code:77336-4546
Mailing Address - Country:US
Mailing Address - Phone:832-233-2331
Mailing Address - Fax:
Practice Address - Street 1:13841 HIGHWAY 59 STE C
Practice Address - Street 2:
Practice Address - City:SPLENDORA
Practice Address - State:TX
Practice Address - Zip Code:77372-5448
Practice Address - Country:US
Practice Address - Phone:281-689-7700
Practice Address - Fax:281-689-7701
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX235056183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician