Provider Demographics
NPI:1508470154
Name:NASHED, NIRVANA (PHARMD)
Entity Type:Individual
Prefix:MISS
First Name:NIRVANA
Middle Name:
Last Name:NASHED
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VIDOR
Mailing Address - State:TX
Mailing Address - Zip Code:77662-3726
Mailing Address - Country:US
Mailing Address - Phone:409-769-1171
Mailing Address - Fax:409-769-0231
Practice Address - Street 1:1305 N MAIN ST
Practice Address - Street 2:
Practice Address - City:VIDOR
Practice Address - State:TX
Practice Address - Zip Code:77662-3726
Practice Address - Country:US
Practice Address - Phone:408-769-1171
Practice Address - Fax:409-769-0231
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64316183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist