Provider Demographics
NPI:1437758729
Name:SHARFA, OMAR
Entity Type:Individual
Prefix:
First Name:OMAR
Middle Name:
Last Name:SHARFA
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 1:250 S EGRET BAY BLVD
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-2682
Mailing Address - Country:US
Mailing Address - Phone:281-332-2551
Mailing Address - Fax:281-554-9032
Practice Address - Street 1:250 S EGRET BAY BLVD
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-2682
Practice Address - Country:US
Practice Address - Phone:281-332-2551
Practice Address - Fax:281-554-9032
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX525511835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1835P0018XOtherPHARMACIST CLINICIAN