Patricia Dianne Shackelford

NPI #1003463712 in Tyler, Texas

Provider Information

NPI Number: 1003463712
Entity Type: Individual
Name: Patricia Dianne Shackelford
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Enumeration Date: Aug 19, 2019
Last Updated: Aug 19, 2019

Practice Location

Address: 11937 US HIGHWAY 271
City: Tyler
State: Texas
ZIP Code: 75708-3154
Phone: (903) 877-7088

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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