Provider Demographics
NPI:1710128947
Name:BAYLOR, SHANEKA D (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHANEKA
Middle Name:D
Last Name:BAYLOR
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 1:1050 W ARKANSAS LN
Mailing Address - Street 2:150
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-6308
Mailing Address - Country:US
Mailing Address - Phone:817-702-6313
Mailing Address - Fax:
Practice Address - Street 1:1050 W ARKANSAS LN
Practice Address - Street 2:150
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-6308
Practice Address - Country:US
Practice Address - Phone:832-259-4523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-18
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX464881835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist