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NPI Code Detail

MEDICARE: TALAL ALTATAR R.PH.

MEDICARE: TALAL ALTATAR R.PH.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist35862TX

General Provider Information

NPI Number : 1134639040
Entity Type Code : Individual
Provider Name (Legal Business Name) : TALAL ALTATAR R.PH.
Provider Business Mailing Address
First Line : 1427 SUMMER FOREST DR
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-6920
Country : US
Telephone Number : 832-434-5236
Fax Number :
Provider Business Practice Location Address
First Line : 121 HIGHWAY 332 W
Second Line :
City : LAKE JACKSON
State : TX
Zip : 77566-4028
Country : US
Telephone Number : 979-297-8578
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2017
Last Update Date : 10/05/2017

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Directions to “ TALAL ALTATAR R.PH.” Practice Location

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