MEDICARE: MR. HIREN RAVAL RPH

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	49702	TX

General Provider Information

NPI Number	:	1376117317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HIREN RAVAL RPH

Provider Business Mailing Address
First Line	:	1205 AVONDALE HASLET RD STE 200
Second Line	:
City	:	HASLET
State	:	TX
Zip	:	76052-3580
Country	:	US
Telephone Number	:	817-945-2608
Fax Number	:	817-945-2609

Provider Business Practice Location Address
First Line	:	1205 AVONDALE HASLET RD STE 200
Second Line	:
City	:	HASLET
State	:	TX
Zip	:	76052-3580
Country	:	US
Telephone Number	:	817-945-2608
Fax Number	:	817-945-2609

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

Provider Enumeration Date	:	05/14/2021
Last Update Date	:	05/14/2021

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Directions to “ MR. HIREN RAVAL RPH” Practice Location

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