Provider Demographics
NPI:1831644152
Name:HASEEBULLAH, TAHIRA IRAM (PHARM D)
Entity Type:Individual
Prefix:
First Name:TAHIRA
Middle Name:IRAM
Last Name:HASEEBULLAH
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 LANTANA BREEZE DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-5638
Mailing Address - Country:US
Mailing Address - Phone:702-236-9439
Mailing Address - Fax:
Practice Address - Street 1:214 LANTANA BREEZE DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89183-5638
Practice Address - Country:US
Practice Address - Phone:702-236-9439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12141183500000X
CA48625183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist