MEDICARE: DR. IMRAN RAJAB ALI PHARMD

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	51765	TX

General Provider Information

NPI Number	:	1821344524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IMRAN RAJAB ALI PHARMD

Provider Business Mailing Address
First Line	:	8532 DAVIS BLVD
Second Line	:	T-1514
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76182-8300
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8532 DAVIS BLVD
Second Line	:	T-1514
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76182-8300
Country	:	US
Telephone Number	:	817-503-0548
Fax Number	:

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

Provider Enumeration Date	:	07/31/2012
Last Update Date	:	07/31/2012

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