Provider Demographics
NPI:1164735130
Name:MYRICK, SHARIE MONIQUE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHARIE MONIQUE
Middle Name:
Last Name:MYRICK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:SHARIE
Other - Middle Name:
Other - Last Name:MYRICK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:5441 BABCOCK RD STE 200
Mailing Address - Street 2:PROFESSIONAL PERFORMANCE DEVELOPMENT GROUP, INC.
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-3993
Mailing Address - Country:US
Mailing Address - Phone:210-615-1117
Mailing Address - Fax:210-253-3822
Practice Address - Street 1:5441 BABCOCK RD STE 200
Practice Address - Street 2:PROFESSIONAL PERFORMANCE DEVELOPMENT GROUP, INC.
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-3993
Practice Address - Country:US
Practice Address - Phone:210-615-1117
Practice Address - Fax:210-253-3822
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS42907183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist