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General NPI Number Information
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NPI Number | 1518243484
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Entity Type | Individual
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Provider Name | MINA AZARI PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/24/2011
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Last Update Date | 10/24/2011
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Provider Practice Location Address
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Address Line | 10600 W PARMER LN
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City | AUSTIN
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State | TX
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Zip | 78717-4627
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Country | US
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Telephone | 512-238-7124
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Fax |
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Provider Business Mailing Address
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Address Line | 13420 LYNDHURST ST APT 103
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City | AUSTIN
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State | TX
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Zip | 78729-1912
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Country | US
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Telephone | 512-788-0133
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 43415
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License Number State | TX
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