Provider Demographics
NPI:1043830037
Name:SHAHRZAD, RUJA (PHARM D)
Entity Type:Individual
Prefix:
First Name:RUJA
Middle Name:
Last Name:SHAHRZAD
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21106 KUYKENDAHL RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-3300
Mailing Address - Country:US
Mailing Address - Phone:281-355-6325
Mailing Address - Fax:281-355-6799
Practice Address - Street 1:21106 KUYKENDAHL RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-3300
Practice Address - Country:US
Practice Address - Phone:281-355-6325
Practice Address - Fax:281-355-6799
Is Sole Proprietor?:No
Enumeration Date:2020-04-20
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61152183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist