Provider Demographics
NPI:1528399557
Name:JAHANGIR, MASUMA J (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MASUMA
Middle Name:J
Last Name:JAHANGIR
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-3010
Mailing Address - Country:US
Mailing Address - Phone:972-727-6509
Mailing Address - Fax:972-727-7421
Practice Address - Street 1:510 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-3010
Practice Address - Country:US
Practice Address - Phone:972-727-6509
Practice Address - Fax:972-727-7421
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-14
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA038074183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist