Provider Demographics
NPI:1588234736
Name:SAXENA, AMIT (PHARMD PHD)
Entity Type:Individual
Prefix:DR
First Name:AMIT
Middle Name:
Last Name:SAXENA
Suffix:
Gender:M
Credentials:PHARMD PHD
Other - Prefix:DR
Other - First Name:AMIT
Other - Middle Name:
Other - Last Name:SAXENA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD PHD
Mailing Address - Street 1:1500 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-4917
Mailing Address - Country:US
Mailing Address - Phone:817-702-5818
Mailing Address - Fax:
Practice Address - Street 1:1500 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4917
Practice Address - Country:US
Practice Address - Phone:817-702-5818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX588981835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist