Provider Demographics
NPI:1992034573
Name:BROWN, SHELLEY ANNETTE (RPH)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:ANNETTE
Last Name:BROWN
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 1:30719 ALDINE WESTFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-3373
Mailing Address - Country:US
Mailing Address - Phone:618-792-6239
Mailing Address - Fax:
Practice Address - Street 1:19215 I-45 SOUTH
Practice Address - Street 2:
Practice Address - City:SHENNANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77382
Practice Address - Country:US
Practice Address - Phone:281-419-6247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47185183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist