Provider Demographics
NPI:1437646999
Name:MORADI, SOHIL
Entity Type:Individual
Prefix:
First Name:SOHIL
Middle Name:
Last Name:MORADI
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 1:17115 BARCELONA DR
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-4164
Mailing Address - Country:US
Mailing Address - Phone:713-703-4273
Mailing Address - Fax:
Practice Address - Street 1:17115 BARCELONA DR
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-4164
Practice Address - Country:US
Practice Address - Phone:713-703-4273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063823183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist