Healthcare Provider Details

I. General information

NPI: 1184599151
Provider Name (Legal Business Name): SHAHROUZ SHOGHI PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 10/24/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6202 HARRY HINES BLVD
DALLAS TX
75390-0001
US

IV. Provider business mailing address

6202 HARRY HINES BLVD
DALLAS TX
75390-0001
US

V. Phone/Fax

Practice location:
  • Phone: 214-645-2682
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number62824
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: