Provider Demographics
NPI:1437659588
Name:SHEFFIELD, SHELBY CHERIE
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:CHERIE
Last Name:SHEFFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 WILBARGER ST
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:TX
Mailing Address - Zip Code:76384-4574
Mailing Address - Country:US
Mailing Address - Phone:940-552-2600
Mailing Address - Fax:940-552-5033
Practice Address - Street 1:3000 WILBARGER ST
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:TX
Practice Address - Zip Code:76384
Practice Address - Country:US
Practice Address - Phone:940-552-2600
Practice Address - Fax:940-552-5033
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55356183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX55356OtherTEXAS STATE BROAD OF PHARMACY