Provider Demographics
NPI:1588250617
Name:SHAH, SMITI (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SMITI
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11948 BROWNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-8862
Mailing Address - Country:US
Mailing Address - Phone:347-260-2883
Mailing Address - Fax:
Practice Address - Street 1:200 W CRAWFORD ST
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-4699
Practice Address - Country:US
Practice Address - Phone:903-465-6182
Practice Address - Fax:903-463-4772
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-13
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60567183500000X
OK15801183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX60567OtherTEXAS STATE BOARD OF PHARMACY
OK15801OtherOKLAHOMA STATE BOARD OF PHARMACY