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NPI Code Detail

MEDICARE: MR. AHMED SAMY FATI

MEDICARE: MR. AHMED SAMY FATI
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
1183500000XPharmacist47417TX

General Provider Information

NPI Number : 1205164100
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. AHMED SAMY FATI
Provider Business Mailing Address
First Line : 9625 WHITE SETTLEMENT RD
Second Line : WALGREENS PHARMACY
City : FORT WORTH
State : TX
Zip : 76108-4406
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9625 WHITE SETTLEMENT RD
Second Line : WALGREENS PHARMACY
City : FORT WORTH
State : TX
Zip : 76108-4406
Country : US
Telephone Number : 817-367-3469
Fax Number : 817-367-3560
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2009
Last Update Date : 12/03/2009

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