Provider Demographics
NPI:1164146932
Name:NASHAWI, AHMAD KHALED
Entity Type:Individual
Prefix:
First Name:AHMAD
Middle Name:KHALED
Last Name:NASHAWI
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 1:815 E ABRAM ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-1212
Mailing Address - Country:US
Mailing Address - Phone:817-804-0124
Mailing Address - Fax:817-804-0159
Practice Address - Street 1:1825 LAKE GLEN TRL
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-4091
Practice Address - Country:US
Practice Address - Phone:682-521-9865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37543183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist