Provider Demographics
NPI:1578237418
Name:ALZEWOANE, HANI
Entity Type:Individual
Prefix:
First Name:HANI
Middle Name:
Last Name:ALZEWOANE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7511 DANIEL KRUG
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-4405
Mailing Address - Country:US
Mailing Address - Phone:210-900-5110
Mailing Address - Fax:
Practice Address - Street 1:9050 FM 1560 N
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-9604
Practice Address - Country:US
Practice Address - Phone:210-900-5110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38590183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist