Provider Demographics
NPI:1225633142
Name:RIZVI, BANEEN
Entity Type:Individual
Prefix:
First Name:BANEEN
Middle Name:
Last Name:RIZVI
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 1:6220 SIENNA PKWY
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-6048
Mailing Address - Country:US
Mailing Address - Phone:281-778-9980
Mailing Address - Fax:
Practice Address - Street 1:6220 SIENNA PKWY
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-6048
Practice Address - Country:US
Practice Address - Phone:281-778-9980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66696183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist