Provider Demographics
NPI:1861776452
Name:ROBERTS, SHARA (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:SHARA
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 TEHAMA RIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76177-2004
Mailing Address - Country:US
Mailing Address - Phone:817-806-9843
Mailing Address - Fax:817-806-9834
Practice Address - Street 1:8900 TEHAMA RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76177-2004
Practice Address - Country:US
Practice Address - Phone:817-806-9843
Practice Address - Fax:817-806-9834
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-01
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18137183500000X
MO2002020486183500000X
TX54466183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist