Provider Demographics
NPI:1275900128
Name:SHAHIWALA, KIRAT (PHARMD, BSPHARM)
Entity Type:Individual
Prefix:DR
First Name:KIRAT
Middle Name:
Last Name:SHAHIWALA
Suffix:
Gender:M
Credentials:PHARMD, BSPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2726 W MOCKINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-5633
Mailing Address - Country:US
Mailing Address - Phone:214-350-2900
Mailing Address - Fax:214-350-2904
Practice Address - Street 1:2726 W MOCKINGBIRD LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-5633
Practice Address - Country:US
Practice Address - Phone:214-350-2900
Practice Address - Fax:214-350-2904
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-26
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020404551835P0018X
TX603931835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist