Provider Demographics
NPI:1477177046
Name:ABUGHAZALEH, HUSSAM (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:HUSSAM
Middle Name:
Last Name:ABUGHAZALEH
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13303 W AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-5800
Mailing Address - Country:US
Mailing Address - Phone:832-939-8137
Mailing Address - Fax:832-939-8128
Practice Address - Street 1:13303 W AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5800
Practice Address - Country:US
Practice Address - Phone:832-939-8137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-30
Last Update Date:2020-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62748183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist