Provider Demographics
NPI:1093120396
Name:ROSTAMI, BEHNAM (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BEHNAM
Middle Name:
Last Name:ROSTAMI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 CATSKILL CT
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-4212
Mailing Address - Country:US
Mailing Address - Phone:214-498-1244
Mailing Address - Fax:
Practice Address - Street 1:2774 E. ELDORADO PARKWAY
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068
Practice Address - Country:US
Practice Address - Phone:972-987-4106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX54711183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist