Provider Demographics
NPI:1346577293
Name:WILLIAMS, SHIMITRE RACHELLE (RPH)
Entity Type:Individual
Prefix:
First Name:SHIMITRE
Middle Name:RACHELLE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 S GORDON ST
Mailing Address - Street 2:
Mailing Address - City:ALVIN
Mailing Address - State:TX
Mailing Address - Zip Code:77511-3460
Mailing Address - Country:US
Mailing Address - Phone:281-585-2404
Mailing Address - Fax:281-585-0709
Practice Address - Street 1:1620 S GORDON ST
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-3460
Practice Address - Country:US
Practice Address - Phone:281-585-2404
Practice Address - Fax:281-585-0709
Is Sole Proprietor?:No
Enumeration Date:2009-11-13
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist