=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134593163
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NASRIN AKBARLOYSHABGAHI PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/13/2015
-----------------------------------------------------
Last Update Date | 11/13/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2015 RUAN RUN CT
-----------------------------------------------------
City | SUGARLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77478
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 612-998-2180
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2015 RYANS RUN CT
-----------------------------------------------------
City | SUGAR LAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77478-4415
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 53058
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------