Provider Demographics
NPI:1821768078
Name:JANI, SAMIR K (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SAMIR
Middle Name:K
Last Name:JANI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 GRANTS LAKE BLVD UNIT 17871
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-0887
Mailing Address - Country:US
Mailing Address - Phone:832-264-5783
Mailing Address - Fax:
Practice Address - Street 1:11 CASTELLO LN
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-1119
Practice Address - Country:US
Practice Address - Phone:832-264-5783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-19
Last Update Date:2021-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX573591835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX57359OtherTSBP