Provider Demographics
NPI:1578984076
Name:FAHMY, BAHER (RPH, PHD)
Entity Type:Individual
Prefix:DR
First Name:BAHER
Middle Name:
Last Name:FAHMY
Suffix:
Gender:M
Credentials:RPH, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 N 16TH ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77630-2382
Mailing Address - Country:US
Mailing Address - Phone:409-886-3546
Mailing Address - Fax:
Practice Address - Street 1:2425 N 16TH ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-2382
Practice Address - Country:US
Practice Address - Phone:409-886-3546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-30
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX46835183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist