Provider Demographics
NPI:1083219026
Name:ALJOHAR, SAFAA
Entity Type:Individual
Prefix:
First Name:SAFAA
Middle Name:
Last Name:ALJOHAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 GRAY ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8608
Mailing Address - Country:US
Mailing Address - Phone:713-982-5527
Mailing Address - Fax:713-982-5533
Practice Address - Street 1:402 GRAY ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8608
Practice Address - Country:US
Practice Address - Phone:713-982-5527
Practice Address - Fax:713-982-5533
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX56484183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist