Provider Demographics
NPI:1003417130
Name:OMRAN, SUHEIB (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:SUHEIB
Middle Name:
Last Name:OMRAN
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 JENNIFER DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-3966
Mailing Address - Country:US
Mailing Address - Phone:469-231-3815
Mailing Address - Fax:
Practice Address - Street 1:2636 W WALNUT ST STE 300
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-6485
Practice Address - Country:US
Practice Address - Phone:469-931-2159
Practice Address - Fax:469-931-2158
Is Sole Proprietor?:No
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64839183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist