MEDICARE: DR. RIZWANA ISLAM PHARM.D.

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
1	183500000X	Pharmacist	52375	TX

General Provider Information

NPI Number	:	1821332321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RIZWANA ISLAM PHARM.D.

Provider Business Mailing Address
First Line	:	5750 PINELAND DR STE 344
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-5300
Country	:	US
Telephone Number	:	214-221-0855
Fax Number	:	972-354-8722

Provider Business Practice Location Address
First Line	:	5750 PINELAND DR STE 344
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-5300
Country	:	US
Telephone Number	:	214-221-0855
Fax Number	:	972-354-8722

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2012
Last Update Date	:	12/02/2022

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