Provider Demographics
NPI:1003410291
Name:JAFFRY, ALIZA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALIZA
Middle Name:
Last Name:JAFFRY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 S COLONY BLVD
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-7331
Mailing Address - Country:US
Mailing Address - Phone:972-624-0605
Mailing Address - Fax:
Practice Address - Street 1:5300 S COLONY BLVD
Practice Address - Street 2:
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-7331
Practice Address - Country:US
Practice Address - Phone:972-624-0605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-28
Last Update Date:2020-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66201183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist