Provider Demographics
NPI:1134552441
Name:TAYLOR, SHELLY CATE (PHARMD)
Entity type:Individual
Prefix:
First Name:SHELLY
Middle Name:CATE
Last Name:TAYLOR
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 1:12340 ALAMEDA TRACE CIR
Mailing Address - Street 2:APT 2810
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-7117
Mailing Address - Country:US
Mailing Address - Phone:512-660-1683
Mailing Address - Fax:
Practice Address - Street 1:12340 ALAMEDA TRACE CIR
Practice Address - Street 2:APT 2810
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78727-7117
Practice Address - Country:US
Practice Address - Phone:512-660-1683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-11
Last Update Date:2013-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53707183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist