Provider Demographics
NPI:1073250163
Name:ELMI, NAZANIN
Entity Type:Individual
Prefix:DR
First Name:NAZANIN
Middle Name:
Last Name:ELMI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1163 W 24TH ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1821
Mailing Address - Country:US
Mailing Address - Phone:713-859-0390
Mailing Address - Fax:
Practice Address - Street 1:1001 WAUGH DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-3901
Practice Address - Country:US
Practice Address - Phone:713-807-7859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69203183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist