MEDICARE: HIJAB MUMTAZ MAKDA PHARMD

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	71269	TX

General Provider Information

NPI Number	:	1821709882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HIJAB MUMTAZ MAKDA PHARMD

Provider Business Mailing Address
First Line	:	4600 BROADWAY
Second Line	:
City	:	ALAMO HEIGHTS
State	:	TX
Zip	:	78209-6214
Country	:	US
Telephone Number	:	201-824-1679
Fax Number	:

Provider Business Practice Location Address
First Line	:	4600 BROADWAY
Second Line	:
City	:	ALAMO HEIGHTS
State	:	TX
Zip	:	78209-6214
Country	:	US
Telephone Number	:	201-824-1679
Fax Number	:

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

Provider Enumeration Date	:	12/12/2022
Last Update Date	:	12/12/2022

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