Provider Demographics
NPI:1720711153
Name:LADHA, SHITAL P (RPH)
Entity Type:Individual
Prefix:
First Name:SHITAL
Middle Name:P
Last Name:LADHA
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 1:13604 LIGHTNING FALLS LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-0515
Mailing Address - Country:US
Mailing Address - Phone:713-724-4601
Mailing Address - Fax:
Practice Address - Street 1:12002 SHADOW CREEK PKWY STE 106
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7325
Practice Address - Country:US
Practice Address - Phone:346-207-8588
Practice Address - Fax:346-207-8660
Is Sole Proprietor?:No
Enumeration Date:2022-07-04
Last Update Date:2022-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX48317183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist