Provider Demographics
NPI:1558648428
Name:MOHAMUD, SULEIMAN SHARIF (RPH)
Entity Type:Individual
Prefix:
First Name:SULEIMAN
Middle Name:SHARIF
Last Name:MOHAMUD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4036 ESTERS RD
Mailing Address - Street 2:APT 2024
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-6740
Mailing Address - Country:US
Mailing Address - Phone:214-212-0299
Mailing Address - Fax:
Practice Address - Street 1:2253 CENTRAL BLVD DR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021
Practice Address - Country:US
Practice Address - Phone:817-868-9202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50615183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist