Provider Demographics
NPI:1598851073
Name:DESAI, SHITAL (PHARMD, BCPS)
Entity type:Individual
Prefix:DR
First Name:SHITAL
Middle Name:
Last Name:DESAI
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6414 FANNIN ST
Mailing Address - Street 2:STE G100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1517
Mailing Address - Country:US
Mailing Address - Phone:713-704-2626
Mailing Address - Fax:
Practice Address - Street 1:6414 FANNIN ST
Practice Address - Street 2:STE G100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1517
Practice Address - Country:US
Practice Address - Phone:713-704-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.2889711835P1200X
TX450751835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy