Provider Demographics
NPI:1902409808
Name:SHINI, RENAS (R PH)
Entity Type:Individual
Prefix:
First Name:RENAS
Middle Name:
Last Name:SHINI
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 REDBUD DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-6383
Mailing Address - Country:US
Mailing Address - Phone:469-951-3843
Mailing Address - Fax:
Practice Address - Street 1:8940 COIT RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-3804
Practice Address - Country:US
Practice Address - Phone:972-377-4966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-21
Last Update Date:2020-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67436183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist