Provider Demographics
NPI:1558953224
Name:SHAHATET, LUNA SULAIMAN (RPH)
Entity Type:Individual
Prefix:
First Name:LUNA
Middle Name:SULAIMAN
Last Name:SHAHATET
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 1:22418 KENDALL SHAY CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-8215
Mailing Address - Country:US
Mailing Address - Phone:832-874-4711
Mailing Address - Fax:
Practice Address - Street 1:22418 KENDALL SHAY CT
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-8215
Practice Address - Country:US
Practice Address - Phone:832-874-4711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP043570L183500000X
TX65652183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist