Provider Demographics
NPI:1063708048
Name:LEBLANC, SHAVON LANAE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:SHAVON
Middle Name:LANAE
Last Name:LEBLANC
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 ELDRIDGE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082
Mailing Address - Country:US
Mailing Address - Phone:281-810-5252
Mailing Address - Fax:281-810-5262
Practice Address - Street 1:2700 ELDRIDGE PKWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-6870
Practice Address - Country:US
Practice Address - Phone:281-810-5252
Practice Address - Fax:281-810-5262
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41878183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist