Healthcare Provider Details

I. General information

NPI: 1093626566
Provider Name (Legal Business Name): ARIA SHOOP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2409 UNIVERSITY AVE
AUSTIN TX
78712-1112
US

IV. Provider business mailing address

22608 N 54TH PL
PHOENIX AZ
85054-7176
US

V. Phone/Fax

Practice location:
  • Phone: 480-646-6857
  • Fax:
Mailing address:
  • Phone: 480-646-6857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number44135
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: