Provider Demographics
NPI:1154909554
Name:NAEM, SHILA (PHARMD)
Entity type:Individual
Prefix:
First Name:SHILA
Middle Name:
Last Name:NAEM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:SHILA
Other - Middle Name:
Other - Last Name:NAEM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:510 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-3010
Mailing Address - Country:US
Mailing Address - Phone:972-727-6509
Mailing Address - Fax:
Practice Address - Street 1:510 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-3010
Practice Address - Country:US
Practice Address - Phone:972-727-6509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66323183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1215942289Medicaid