Provider Demographics
NPI:1093449738
Name:DAMIRI, ANAS I (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANAS
Middle Name:
Last Name:DAMIRI
Suffix:I
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 1:337 HARDWICKE DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-2414
Mailing Address - Country:US
Mailing Address - Phone:865-789-0089
Mailing Address - Fax:
Practice Address - Street 1:2101 DONLEY DR STE 105
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-4512
Practice Address - Country:US
Practice Address - Phone:512-458-3983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-09
Last Update Date:2022-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68904183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist