Healthcare Provider Details

I. General information

NPI: 1962401711
Provider Name (Legal Business Name): SADEGH M MALEKI-NOUJEDEHI PHARM.D, R.PH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

Provider Other Name: MOHAMMADSADEGH MALEKI NOUJEDEHI PHARM.D

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1504 TAUB LOOP BEN TAUB (HCHD) HOSPITAL, PHARMACY DEPARTMENT
HOUSTON TX
77030-1608
US

IV. Provider business mailing address

6507 PINEWOOD TRACE LN
HOUSTON TX
77041-7242
US

V. Phone/Fax

Practice location:
  • Phone: 713-873-2980
  • Fax: 713-272-5550
Mailing address:
  • Phone: 713-937-9809
  • Fax: 713-272-5550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number34290
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: