Provider Demographics
NPI:1184256653
Name:CAIN, SHAUNEEN M (RPH)
Entity type:Individual
Prefix:
First Name:SHAUNEEN
Middle Name:M
Last Name:CAIN
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 1:5330 S COOPER ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-5938
Mailing Address - Country:US
Mailing Address - Phone:817-472-9576
Mailing Address - Fax:817-472-0231
Practice Address - Street 1:5330 S COOPER ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-5938
Practice Address - Country:US
Practice Address - Phone:817-472-9576
Practice Address - Fax:817-472-0231
Is Sole Proprietor?:No
Enumeration Date:2020-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX391911835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist