Provider Demographics
NPI:1578286423
Name:ZAMAN, FERUJA (PHARMD)
Entity Type:Individual
Prefix:
First Name:FERUJA
Middle Name:
Last Name:ZAMAN
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 1:1717 SHILOH RD APT 266
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-2449
Mailing Address - Country:US
Mailing Address - Phone:404-563-4970
Mailing Address - Fax:
Practice Address - Street 1:119 W MARSHALL AVE
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5340
Practice Address - Country:US
Practice Address - Phone:903-753-2686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70514183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1989OtherPHARMACY