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General NPI Number Information
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NPI Number | 1568936391
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Entity Type | Individual
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Provider Name | IBRAHEEM PEDRO PHARM D
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Gender | Male
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Dates
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Enumeration Date | 01/15/2019
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Last Update Date | 04/05/2021
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Provider Practice Location Address
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Address Line | 3533 S DAIRY ASHFORD RD SUITE G
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City | HOUSTON
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State | TX
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Zip | 77082
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Country | US
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Telephone | 832-328-7301
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Fax | 832-288-3764
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Provider Business Mailing Address
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Address Line | COMMUNITY OF HOUSTON PHARMACY LLC 3533 S DAIRY ASHFORD RD SUITE G
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City | HOUSTON
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State | TX
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Zip | 77082
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Country | US
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Telephone | 832-328-7301
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Fax | 832-288-3764
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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 | 55829
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 32129
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License Number State | TX
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