1962401711 NPI number — DR. SADEGH M MALEKI-NOUJEDEHI PHARM.D, R.PH

Table of content: DR. SADEGH M MALEKI-NOUJEDEHI PHARM.D, R.PH (NPI 1962401711)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962401711 NPI number — DR. SADEGH M MALEKI-NOUJEDEHI PHARM.D, R.PH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MALEKI-NOUJEDEHI
Provider First Name:
SADEGH
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARM.D, R.PH
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MALEKI NOUJEDEHI
Provider Other First Name:
MOHAMMADSADEGH
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARM.D
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1962401711
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6507 PINEWOOD TRACE LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77041-7242
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-937-9809
Provider Business Mailing Address Fax Number:
713-272-5550

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1504 TAUB LOOP
Provider Second Line Business Practice Location Address:
BEN TAUB (HCHD) HOSPITAL, PHARMACY DEPARTMENT
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030-1608
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-873-2980
Provider Business Practice Location Address Fax Number:
713-272-5550
Provider Enumeration Date:
07/14/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1835P1200X , with the licence number:  34290 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 34290 . This is a "REGISTERED PHARMACSIT" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".