Provider Demographics
NPI:1295056760
Name:SHIPP, BELINDA PRUETT (PHARMACIST)
Entity type:Individual
Prefix:MRS
First Name:BELINDA
Middle Name:PRUETT
Last Name:SHIPP
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6911 RANCH ROAD 620 N
Mailing Address - Street 2:WALGREENS
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732-1920
Mailing Address - Country:US
Mailing Address - Phone:512-219-8533
Mailing Address - Fax:512-219-8529
Practice Address - Street 1:6911 RANCH ROAD 620 N
Practice Address - Street 2:WALGREENS
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-1920
Practice Address - Country:US
Practice Address - Phone:512-219-8533
Practice Address - Fax:512-219-8529
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21168183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist