PATRICIA DIANNE SHACKELFORD (NPI# 1003463712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003463712 |
| Entity Type | Individual |
| Full Name | PATRICIA DIANNE SHACKELFORD |
| Practice Address |
11937 Us Highway 271 Tyler TX 75708-3154 |
| Practice Telephone | 9038777088 |
| Practice Fax Number | 9038777006 |
| Mailing Telephone | 9038777088 |
| Mailing Fax Number | 9038777006 |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2019-08-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 26982 | TX | Pharmacy Service Providers |
| Street Address |
11937 US HIGHWAY 271 |
| City | TYLER |
| State | TX |
| Zip Code | 75708-3154 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245233550 | Frances L. Elizondo | Physician Assistant | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2005-05-31 |
| 1497355481 | Jessie Ann Gibson | Dietitian, Registered | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-10-28 |
| 1538767397 | Ian Joseph Gomez | Dietitian, Registered | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-10-14 |
| 1588262562 | Jamie R Antwine | Dietitian, Registered | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-10-13 |
| 1679171797 | Christian Paul Fant | Dietitian, Registered | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-10-12 |
| 1912512468 | Halle Ross-young | Psychologist | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-09-11 |
| 1093328700 | Joshua Morgan | Student in an Organized Health Care Education/Training Program | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-08-24 |
| 1811509011 | Kavya Parasa | Student in an Organized Health Care Education/Training Program | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-08-19 |
| 1326657792 | Pelin D Strebler | Clinical Neuropsychologist | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-07-30 |
| 1508483082 | Chi Nguyen Benson | Student in an Organized Health Care Education/Training Program | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-06-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427615699 | Aiat Radwan | Student in an Organized Health Care Education/Training Program | 11937 U Highway 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-23 |
| 1174170781 | Sanmitha Sundaram Kota | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-08-20 |
| 1952960437 | Parashar Trivedi | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-06-10 |
| 1659937506 | Sandhya Devaraj | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-16 |
| 1972169381 | Mary Kaar | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-13 |
| 1396301701 | Joshua Penrod | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-13 |
| 1558927962 | Ijeoma Nwaigwe | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-13 |
| 1487210894 | David Pollard | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-13 |
| 1477119873 | Aparna Kanuparthy | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-13 |
| 1275199689 | Prithvi Muddana | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-13 |
| Find all providers in zip 75708 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669073433 | Josephine S Asamoah | Pharmacist | 3820 Tx-64, Tyler, TX 75704-5582 | 2020-11-06 |
| 1790386738 | Jennifer O Jackson | Pharmacist | 1900 Ese Loop323, Tyler, TX 75701-8337 | 2020-11-05 |
| 1528669132 | Youness Ennouri | Pharmacist | 2025 Ssw Loop 323, Tyler, TX 75701-0763 | 2020-11-02 |
| 1194325415 | Rupal R Patel | Pharmacist | 3820 Tx 64, Tyler, TX 75704 | 2020-10-27 |
| 1528673597 | Holly Beth Lutmer | Pharmacist | 4901 Kinsey Dr Apt 1723, Tyler, TX 75703-3033 | 2020-09-15 |
| 1558976498 | Traci Carroll George | Pharmacist | 1600 W Sw Loop 323, Tyler, TX 75701-8532 | 2020-09-08 |
| 1538773213 | Zachary Thompson | Pharmacist | 19201 Oakbrook Rd, Tyler, TX 75703-8233 | 2020-09-01 |
| 1699392407 | Cathlyn Yu | Pharmacist | 13157 Hwy 271, Tyler, TX 75708-2453 | 2020-06-26 |
| 1245878826 | Kim Annette Parks | Pharmacist | 113 Nnw Loop 323, Tyler, TX 75702-8725 | 2019-12-14 |
| 1366003063 | Austin J Dowell | Pharmacist | 4290 Kinsey Dr Ste 100, Tyler, TX 75703-1022 | 2019-06-24 |
| Find all providers in TYLER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.