Provider Demographics
NPI:1053656181
Name:GARRETT-SHELTON, JUDITH A (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:A
Last Name:GARRETT-SHELTON
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6955 ALMEDA RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77021-2009
Mailing Address - Country:US
Mailing Address - Phone:800-505-2980
Mailing Address - Fax:800-398-4615
Practice Address - Street 1:6955 ALMEDA RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-2009
Practice Address - Country:US
Practice Address - Phone:800-505-2980
Practice Address - Fax:800-398-4615
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26724183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX26724OtherPHARMACIST