MEDICARE: DR. ROXANNA SHEREEN HONARPOUR

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	52007	TX

General Provider Information

NPI Number	:	1104457704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROXANNA SHEREEN HONARPOUR

Provider Business Mailing Address
First Line	:	23315 MEADOW CROSS LN
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-2143
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12222 JONES RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-5283
Country	:	US
Telephone Number	:	832-912-7578
Fax Number	:

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

Provider Enumeration Date	:	02/01/2020
Last Update Date	:	02/01/2020

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