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General NPI Number Information
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NPI Number | 1770924839
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Entity Type | Individual
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Provider Name | FARID REZAEI PHARMACIST
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Gender | Male
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Dates
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Enumeration Date | 07/17/2013
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Last Update Date | 07/17/2013
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Provider Practice Location Address
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Address Line | 11711 MEMORIAL DR 505
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City | HOUSTON
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State | TX
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Zip | 77024-7255
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Country | US
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Telephone | 936-296-3041
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Fax | 936-295-6815
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Provider Business Mailing Address
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Address Line | 141 I-45 SOUTH
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City | HUNTSVILLE
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State | TX
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Zip | 77340
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Country | US
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Telephone | 936-296-3041
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Fax | 936-295-6815
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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 | 48483
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License Number State | TX
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