=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497332274
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHIMOLI DOSHI PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/26/2021
-----------------------------------------------------
Last Update Date | 03/26/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4541 N JOSEY LN STE 250
-----------------------------------------------------
City | CARROLLTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75010-4781
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-201-9343
-----------------------------------------------------
Fax | 972-201-9344
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4541 N JOSEY LN STE 250
-----------------------------------------------------
City | CARROLLTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75010-4781
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-201-9343
-----------------------------------------------------
Fax | 972-201-9344
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 54434
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------