Healthcare Provider Details

I. General information

NPI: 1972804540
Provider Name (Legal Business Name): NILOFER N PERVEZ ARTHUR PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NILOFER PERVEZ RPH

II. Dates (important events)

Enumeration Date: 11/12/2010
Last Update Date: 11/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 BERGQUIST DR STE 1 LACKLAND AIR FORCE BASE
LACKLAND A F B TX
78236-9908
US

IV. Provider business mailing address

150 RUSTLEAF DR APT # 20 B
SAN ANTONIO TX
78242-1215
US

V. Phone/Fax

Practice location:
  • Phone: 210-292-7216
  • Fax:
Mailing address:
  • Phone: 509-301-5544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number034882
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: