MEDICARE: MRS. SHARA ROBERTS PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	18137	MD
2	183500000X	Pharmacist	2002020486	MO
3	183500000X	Pharmacist	54466	TX

General Provider Information

NPI Number	:	1861776452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHARA ROBERTS PHARM.D.

Provider Business Mailing Address
First Line	:	8900 TEHAMA RIDGE PKWY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-2004
Country	:	US
Telephone Number	:	817-806-9843
Fax Number	:	817-806-9834

Provider Business Practice Location Address
First Line	:	8900 TEHAMA RIDGE PKWY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-2004
Country	:	US
Telephone Number	:	817-806-9843
Fax Number	:	817-806-9834

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2011
Last Update Date	:	08/20/2021

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