Provider Demographics
NPI:1407201056
Name:HOWARD, SHELLY LEANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:SHELLY
Middle Name:LEANN
Last Name:HOWARD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 TEJAS DR
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-4742
Mailing Address - Country:US
Mailing Address - Phone:806-330-1249
Mailing Address - Fax:
Practice Address - Street 1:200 N GRAND AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240-4320
Practice Address - Country:US
Practice Address - Phone:940-665-7622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39246183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist