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General NPI Number Information
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NPI Number | 1982996005
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Entity Type | Individual
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Provider Name | MARIAN MAMDOUH ABDALLA HANN ELMALAH
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Gender | Female
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Dates
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Enumeration Date | 05/08/2011
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Last Update Date | 03/15/2016
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Provider Practice Location Address
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Address Line | 3525 SYCAMORE SCHOOL RD
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City | FORT WORTH
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State | TX
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Zip | 76133-7805
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Country | US
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Telephone | 817-346-4457
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Fax |
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Provider Business Mailing Address
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Address Line | 2513 WILDWOOD WAY
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City | KELLER
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State | TX
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Zip | 76262-8811
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Country | US
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Telephone | 216-235-4332
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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 | 03329091
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License Number State | OH
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