Provider Demographics
NPI:1164698700
Name:OUTLAND, SHENITA A (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:SHENITA
Middle Name:A
Last Name:OUTLAND
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 LAKES AT 610 DR
Mailing Address - Street 2:PHARMACY ADMINISTRATION
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2525
Mailing Address - Country:US
Mailing Address - Phone:713-442-5407
Mailing Address - Fax:713-442-5253
Practice Address - Street 1:8900 LAKES AT 610 DR
Practice Address - Street 2:PHARMACY ADMINISTRATION
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2525
Practice Address - Country:US
Practice Address - Phone:713-442-5407
Practice Address - Fax:713-442-5253
Is Sole Proprietor?:No
Enumeration Date:2008-05-04
Last Update Date:2008-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44889183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist