Provider Demographics
NPI:1366468662
Name:HAIJA, ALI (PHARM-D)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:HAIJA
Suffix:
Gender:M
Credentials:PHARM-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 N RACHEL CT
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-6372
Mailing Address - Country:US
Mailing Address - Phone:832-606-2583
Mailing Address - Fax:713-944-8890
Practice Address - Street 1:4024A BROOKHAVEN AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1902
Practice Address - Country:US
Practice Address - Phone:713-944-8893
Practice Address - Fax:713-944-8890
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26727183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145607Medicaid