Provider Demographics
NPI:1407558521
Name:AL SHARIF, LAITH (RPH)
Entity Type:Individual
Prefix:
First Name:LAITH
Middle Name:
Last Name:AL SHARIF
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3029 HARPER ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-2213
Mailing Address - Country:US
Mailing Address - Phone:682-716-9822
Mailing Address - Fax:
Practice Address - Street 1:1401 W GLADE RD # CVS
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76039-5417
Practice Address - Country:US
Practice Address - Phone:817-399-8486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72087183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist